Bipolar Disorder Group Research Articles

Innovative Neuroimaging Biomarker Distinction of Major Depressive Disorder and Bipolar Disorder through Structural Connectome Analysis and Machine Learning Models.

Major depressive disorder (MDD) and bipolar disorder (BD) share clinical features, which complicates their differentiation in clinical settings. This study proposes an innovative approach that integrates structural connectome analysis with machine learning models to discern individuals with MDD from individuals with BD. High-resolution MRI images were obtained from individuals diagnosed with MDD or BD and from HCs. Structural connectomes were constructed to represent the complex interplay of brain regions using advanced graph theory techniques. Machine learning models were employed to discern unique connectivity patterns associated with MDD and BD. At the global level, both BD and MDD patients exhibited increased small-worldness compared to the HC group. At the nodal level, patients with BD and MDD showed common differences in nodal parameters primarily in the right amygdala and the right parahippocampal gyrus when compared with HCs. Distinctive differences were found mainly in prefrontal regions for BD, whereas MDD was characterized by abnormalities in the left thalamus and default mode network. Additionally, the BD group demonstrated altered nodal parameters predominantly in the fronto-limbic network when compared with the MDD group. Moreover, the application of machine learning models utilizing structural brain parameters demonstrated an impressive 90.3% accuracy in distinguishing individuals with BD from individuals with MDD. These findings demonstrate that combined structural connectome and machine learning enhance diagnostic accuracy and may contribute valuable insights to the understanding of the distinctive neurobiological signatures of these psychiatric disorders.

Too close for comfort? Social distance and emotion perception in remitted bipolar I disorder

Introduction: Bipolar disorder (BD) is a chronic psychiatric disorder that is associated with heightened and persistent positive emotion (Gruber, 2011; Johnson, 2005). Yet, we know little about how troubled emotion responding may translate into dynamic face-to-face interactions involving others, especially in contexts where automatic social regulation of personal distance from others is key to maintaining social boundaries. Method: Using a novel social distance paradigm adapted from a prior work (Kennedy et al., 2009), participants with a clinical history of bipolar I disorder (n = 30) and healthy controls (CTL; n = 31) provided online measurements of social distance preferences in response to positive, negative, and neutral facial images, as well as subsequent social judgment and emotion perception ratings. Results: Results suggest no group differences on social distance, social perception, or general emotion perception ratings. However, exploratory analyses suggest that the BD group rated positive images higher in happiness, but lower in amusement, compared to the CTL group. Conclusion: These findings contribute to a growing literature on socioemotional processes in BD.

An ERP Study of Face Processing in Schizophrenia, Bipolar Disorder, and Socially Isolated Individuals from the Community.

People with schizophrenia (SCZ) and bipolar disorder (BD) have impairments in processing social information, including faces. The neural correlates of face processing are widely studied with the N170 ERP component. However, it is unclear whether N170 deficits reflect neural abnormalities associated with these clinical conditions or differences in social environments. The goal of this study was to determine whether N170 deficits would still be present in SCZ and BD when compared with socially isolated community members. Participants included 66 people with SCZ, 37 with BD, and 125 community members (76 "Community-Isolated"; 49 "Community-Connected"). Electroencephalography was recorded during a face processing task in which participants identified the gender of a face, the emotion of a face (angry, happy, neutral), or the number of stories in a building. We examined group differences in the N170 face effect (greater amplitudes for faces vs buildings) and the N170 emotion effect (greater amplitudes for emotional vs neutral expressions). Groups significantly differed in levels of social isolation (Community-Isolated > SCZ > BD = Community-Connected). SCZ participants had significantly reduced N170 amplitudes to faces compared with both community groups, which did not differ from each other. The BD group was intermediate and did not differ from any group. There were no significant group differences in the processing of specific emotional facial expressions. The N170 is abnormal in SCZ even when compared to socially isolated community members. Hence, the N170 seems to reflect a social processing impairment in SCZ that is separate from level of social isolation.

Different levels of prepulse inhibition among patients with first-episode schizophrenia, bipolar disorder and major depressive disorder.

Deficits in prepulse inhibition may be a common feature in first-episode schizophrenia, bipolar disorder (BD) and major depressive disorder (MDD). We sought to explore the levels and viability of prepulse inhibition to differentiate first-episode schizophrenia, BD and MDD in patient populations. We tested patients with first-episode schizophrenia, BD or MDD and healthy controls using prepulse inhibition paradigms, namely perceived spatial co-location (PSC-PPI) and perceived spatial separation (PSS-PPI). We included 53 patients with first-episode schizophrenia, 30 with BD and 25 with MDD, as well as 82 healthy controls. The PSS-PPI indicated that the levels of prepulse inhibition were smallest to largest, respectively, in the first-episode schizophrenia, BD, MDD and control groups. Relative to the healthy controls, the prepulse inhibition deficits in the first-episode schizophrenia group were significant (p < 0.001), but the prepulse inhibitions were similar between patients with BD and healthy controls, and between patients with MDD and healthy controls. The receiver operating characteristic curve analysis showed that PSS-PPI (area under the curve [AUC] 0.73, p < 0.001) and latency (AUC 0.72, p < 0.001) were significant for differentiating patients with first-episode schizophrenia or BD from healthy controls. The demographics of the 4 groups were not ideally matched. We did not perform cognitive assessments. The possible confounding effect of medications on prepulse inhibition could not be eliminated. The level of prepulse inhibition among patients with first-episode schizophrenia was the lowest, with levels among patients with BD, patients with MDD and healthy controls increasingly higher. The PSS-PPI paradigm was more effective than PSC-PPI to recognize deficits in prepulse inhibition. These results provide a basis for further research on biological indicators that can assist differential diagnoses in psychosis.

Based on white matter microstructure to early identify bipolar disorder from patients with depressive episode

ObjectiveBecause of similar clinical manifestations, bipolar disorder (BD) patients are often misdiagnosed as major depressive disorder (MDD). This study aimed to compare the difference between depressed patients later converting to BD and unipolar depression (UD) according to diffusion tensor imaging (DTI). MethodPatients with MDD (562 participants) in depressive episode states and healthy controls (HCs) (145 participants) were recruited over 10 years. Demographic and magnetic resonance imaging (MRI) data were collected at the time of recruitment. All patients with MDD were followed up for 5 years and classified into the transfer to BD (tBD) group (83 participants) and UD group (160 participants) according to the follow-up results. DTI and functional magnetic resonance imaging at baseline were compared. ResultsCommon abnormalities were found in both tBD and UD groups, including left superior cerebellar peduncle (SCP.L), right anterior limb of the internal capsule (ALIC.R), right superior fronto-occipital fasciculus (SFOF.R), and right inferior fronto-occipital fasciculus (IFOF.R). The tBD showed more extensive abnormalities than the UD in the body of corpus callosum, fornix, left superior corona radiata, left posterior corona radiata, left superior longitudinal fasciculus, and left superior fronto-occipital fasciculus. ConclusionThe study demonstrated the common and distinct abnormalities of tBD and UD when compared to HC. The tBD group showed more extensive disruptions of white matter integrity, which could be a potential biomarker for the early identification of BD.

Pro/antioxidant status and selenium, zinc and arsenic concentration in patients with bipolar disorder treated with lithium and valproic acid.

Disturbances in pro/antioxidant balance emerge as a crucial element in bipolar disorder (BD). Some studies suggest that treatment effects on trace element concentration in BD. This study aimed to identify (a) the changes related to oxidative stress in BD and their relationship with trace elements engaged in pro/antioxidant homeostasis; (b) BD biomarkers using machine learning algorithm classification and regression tree (C&RT) analysis. 62 individuals with BD and 40 healthy individuals (HC) were included in the study. The concentration of pro/antioxidant state and concentration of selenium, zinc, arsenic in blood were assessed. We found a higher concentration of total antioxidant capacity, catalase, advanced oxidation protein products and a lower concentration of 4-hydroxynonenal (4-HNE), glutathione, glutathione peroxidase (GPx) in BD compared to HC. All examined trace elements were lower in the BD group compared to HC. A combination of two variables, 4-HNE (cut-off: ≤ 0.004 uM/mg protein) and GPx (cut-off: ≤ 0.485 U/mg protein), was the most promising markers for separating the BD from the HC. The area under the receiver operating characteristic curve values for C&RT was 90.5%. Disturbances in the pro/antioxidant state and concentration of trace elements of patients with BD may be a target for new therapeutic or diagnostic opportunity of BD biomarkers.

Factors associated with suicide attempts in the antecedent illness trajectory of bipolar disorder and schizophrenia

BackgroundFactors associated with suicide attempts during the antecedent illness trajectory of bipolar disorder (BD) and schizophrenia (SZ) are poorly understood.MethodsUtilizing the Rochester Epidemiology Project, individuals born after 1985 in Olmsted County, MN, presented with first episode mania (FEM) or psychosis (FEP), subsequently diagnosed with BD or SZ were identified. Patient demographics, suicidal ideation with plan, self-harm, suicide attempts, psychiatric hospitalizations, substance use, and childhood adversities were quantified using the electronic health record. Analyses pooled BD and SZ groups with a transdiagnostic approach given the two diseases were not yet differentiated. Factors associated with suicide attempts were examined using bivariate methods and multivariable logistic regression modeling.ResultsA total of 205 individuals with FEM or FEP (BD = 74, SZ = 131) were included. Suicide attempts were identified in 39 (19%) patients. Those with suicide attempts during antecedent illness trajectory were more likely to be female, victims of domestic violence or bullying behavior, and have higher rates of psychiatric hospitalizations, suicidal ideation with plan and/or self-harm, as well as alcohol, drug, and nicotine use before FEM/FEP onset. Based on multivariable logistic regression, three factors remained independently associated with suicidal attempts: psychiatric hospitalization (OR = 5.84, 95% CI 2.09–16.33, p < 0.001), self-harm (OR = 3.46, 95% CI 1.29–9.30, p = 0.014), and nicotine use (OR = 3.02, 95% CI 1.17–7.76, p = 0.022).ConclusionSuicidal attempts were prevalent during the antecedents of BD and SZ and were associated with several risk factors before FEM/FEP. Their clinical recognition could contribute to improve early prediction and prevention of suicide during the antecedent illness trajectory of BD and SZ.

Longitudinal risk of suicide outcomes in people with severe mental illness following an emergency department visit and the effects of suicide prevention treatment

BackgroundIndividuals with severe mental illness (SMI), including bipolar disorder (BD) and schizophrenia-spectrum disorders (SSD), are at high risk for suicide. However, suicide research often excludes individuals with SMI. The current research examined differences in suicide outcomes (i.e., suicide attempt or death) for adults with and without BD and SSD diagnoses following an emergency department (ED) visit and investigated the efficacy of the Coping Long Term with Active Suicide Program (CLASP) intervention in reducing suicide outcomes among people with SMI. Methods1235 adults presenting with recent suicidality were recruited from 8 different EDs across the United States. Using a quasi-experimental, stepped wedge series design, participants were followed for 52-weeks with or without subsequent provision of CLASP. ResultsParticipants in the SSD group and the BD group had significantly shorter time to and higher rate of suicide outcomes than participants with other psychiatric diagnoses in all study phases and in non-CLASP phases, respectively. Participants with BD receiving the CLASP intervention had significantly longer time to suicide outcomes than those not receiving CLASP; these differences were not observed among those with SSD. LimitationsStudy limitations include self-reported psychiatric diagnosis, exclusion of homeless participants, and small sample size of participants with SSD. ConclusionsParticipants with SMI were at higher risk for suicide outcomes than participants with other psychiatric diagnoses. CLASP was efficacious among those participants with BD. Psychiatric diagnosis may be a key indicator of prospective suicide risk. More intensive and specialized follow-up mental health treatment may be necessary for those with SSD.

Higher Levels of C-reactive Protein Are Associated With Higher Cortical Surface Area and Lower Cortical Thickness in Youth With Bipolar Disorder.

Inflammation is implicated in the neuropathology of bipolar disorder (BD). The association of C-reactive protein (CRP) with brain structure has been examined in relation to BD among adults but not youth. Participants included 101 youth (BD, n = 55; control group [CG], n = 46; aged 13-20 years). Blood samples were assayed for levels of CRP. T1-weighted brain images were acquired to obtain cortical surface area (SA), volume, and thickness for 3 regions of interest (ROI; whole-brain cortical gray matter, prefrontal cortex, orbitofrontal cortex [OFC]) and for vertex-wise analyses. Analyses included CRP main effects and interaction effects controlling for age, sex, and intracranial volume. In ROI analyses, higher CRP was associated with higher whole-brain SA (β = 0.16; P = .03) and lower whole-brain (β = -0.31; P = .03) and OFC cortical thickness (β = -0.29; P = .04) within the BD group and was associated with higher OFC SA (β = 0.17; P = .03) within the CG. In vertex-wise analyses, higher CRP was associated with higher SA and lower cortical thickness in frontal and parietal regions within BD. A significant CRP-by-diagnosis interaction was found in frontal and temporal regions, whereby higher CRP was associated with lower neurostructural metrics in the BD group but higher neurostructural metrics in CG. This study found that higher CRP among youth with BD is associated with higher SA but lower cortical thickness in ROI and vertex-wise analyses. The study identified 2 regions in which the association of CRP with brain structure differs between youth with BD and the CG. Future longitudinal, repeated-measures studies incorporating additional inflammatory markers are warranted.

Verbal memory impairments in mood disorders and psychotic disorders: A systematic review of comparative studies

BackgroundMood and psychotic disorders are both associated with verbal memory impairments. Verbal memory represents an important treatment target for both disorders. However, whether the neurocognitive and neurophysiological profiles of verbal memory impairments differ between specific disorders within these two diagnostic categories and healthy controls remains unclear. The current systematic review synthesized findings from comparative studies which used behavioural and neuroimaging tasks to investigate verbal memory impairments between: (1) mood disorder, psychotic disorder, and healthy control groups; and (2) mood disorder without psychotic features, mood disorder with psychotic features, and healthy control groups. MethodsThe search strategy combined terms related to three main concepts: ‘mood disorders’, ‘psychotic disorders’, and ‘verbal memory’. Searches were executed in Embase, MEDLINE, PsycInfo, and PubMed databases. A total of 38 articles met the full eligibility criteria and were included in the final narrative synthesis. Findings were stratified by memory domain (overall composite score, verbal working memory, immediate recall, delayed recall, and recognition memory) and by illness phase (acute and non-acute). ResultsMood and psychotic disorders displayed consistent verbal memory impairments compared to healthy controls during the acute and non-acute phases. Few significant differences were identified in the literature between mood and psychotic disorders, and between mood disorders with and without psychotic features. Individuals with schizophrenia were found to have decreased immediate and delayed verbal recall performance compared to bipolar disorder groups during the acute phase. Major depressive disorder groups with psychotic features were also found to have decreased delayed verbal recall performance compared to those without psychosis during the acute phase. No consistent differences were identified between mood and psychotic disorders during the non-acute phase. Finally, preliminary evidence suggests there may be functional abnormalities in important frontal and temporal brain regions related to verbal memory difficulties in both mood and psychotic disorders. DiscussionThe current findings have potential implications for the diagnosis and treatment of cognitive impairments in mood and psychotic disorders. Verbal recall memory may serve as a sensitive tool in the risk stratification of cognitive impairments for certain mood and psychotic disorders. Moreover, since no widespread differences between clinical groups were identified, the evidence supports providing targeted interventions for verbal memory, such as pharmacological and non-pharmacological interventions, through a trans-diagnostic approach in mood and psychotic disorders.

White matter integrity in bipolar disorder investigated with diffusion tensor magnetic resonance imaging and fractal geometry

BackgroundGrowing evidence suggests the presence of white matter (WM) alterations in bipolar disorder (BD). In this study we aimed to investigate the state of WM structures, in terms of tissue integrity and morphological complexity, in BD patients compared to healthy controls (HC), in an attempt to better elucidate the microstructural changes associated with BD. MethodsWe collected a dataset of 399 Diffusion Tensor Magnetic Resonance Imaging (167 BD and 232 healthy controls) images, acquired at five different sites, which was processed with Tract-Based Spatial Statistics (TBSS) and fractal analysis. ResultsThe TBSS analysis demonstrated significantly lower FA values in the BD group. Diffusion abnormalities were primarily located in the temporo-parietal network. The Fractal Dimension (FD) analysis did not reveal consistent significant differences in the morphological complexity of WM structures between the groups. When the FD values of patients were considered individually, it is possible to notice some localized significant deviations from the healthy population. LimitationsDTI sequences have not been harmonized before acquisition, samples' sizes are heterogeneous. ConclusionsThis study, by applying both TBSS and FD analyses, allows to evaluate diffusion and structural alterations of WM at the same time. The evaluation of WM integrity from these two different perspectives could be useful to better understand the pathophysiological and morphological changes underpinning bipolar disorder.

Occurrence of Metabolic Syndrome in Untreated Bipolar Disorders: A Cross-Sectional Study.

This cross-sectional study aimed to observe the occurrence of metabolic syndrome in untreated individuals with bipolar disorders. A total of 125 untreated individuals with bipolar disorders were collected as the study group, and 201 cases from the health examination center of our hospital were selected as the control group. The participants enrolled were assessed for general demographic data, case characteristics, and metabolic indexes including body mass index (BMI), blood pressure, triglyceride, HDL-C, cholesterol, LDL-C, and fasting plasma glucose. The incidence of metabolic syndrome in the bipolar disorders group was higher compared to the control group (9.6% VS. 8.5%). After calibrating sex and age data, a significant difference between the two groups was observed (P<0.05). Diastolic and systolic blood pressure were higher in the bipolar disorders group compared to the control group (P<0.01). Men with bipolar disorders had a higher risk of developing metabolic syndrome than women (14.5% vs. 5.8%). Bipolar disorders, sex, age, and BMI were identified as independent risk factors for metabolic syndrome. No significant difference was found in terms of metabolic index and incidence of metabolic syndrome between individuals with depressive episodes (n=37) and manic episodes (n=75). Patients with bipolar disorders were found to have a higher risk of developing metabolic syndrome than healthy individuals. Bipolar disorders, male sex, age, and BMI may contribute to an increased risk of developing metabolic syndrome.

Functional Impairment, Attachment, and Affective Temperaments in Euthymic Patients with Bipolar Disorder.

Functional impairment in euthymic patients with bipolar disorder is a compelling issue, and revealing unknown related factors with functional impairment is a substantial topic. We aimed to assess the effects of clinical factors, affective temperaments, and attachment on overall functioning in euthymic patients with bipolar disorder. Sixty-three patients with bipolar disorder and 61 healthy controls participated in this study. The assessment involved Hamilton Depression Rating Scale; Young Mania Rating Scale; Relationship Scales Questionnaire; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego; and Functioning Assessment Short Test. Secure attachment scores were significantly higher in the control group than in the bipolar disorder group. Depressive, anxious, and cyclothymic temperament scores were significantly higher in the bipolar disorder group. In the bipolar disordergroup higher occupational, cognitive, autonomy, interpersonal relationships, and leisure subdomain and overall functional impairment scores were found than in the healthy control group. Secure attachment scores were significantly and negatively correlated with anxious and depressive temperaments. Secure attachment scores were positively and significantly correlated with hyperthymic temperament scores. Years of education; subclinical depressive symptoms; secure attachment; and cyclothymic, irritable, depressive, hyperthymic, and anxious temperaments were all significantly correlated with the overall functional impairment in the patient group. The cyclothymic and anxious temperament positively predicted the overall functional impairment in the bipolar group, while the secure attachment negatively predicted the overall functional impairment in the regression analysis. The results suggest that, when following up the patients with bipolar disorder in relation to functional impairment, secure attachment, cyclothymic, and anxious temperaments should be taken into consideration.

Effects of Beliefs, Conspiracy Theories, and Vaccine Hesitancy on the Vaccination Status of Patients with Severe Mental Illness in a Tertiary Psychiatric Care Hospital in Türkiye.

The aim of the study was to investigate the relationship between the vaccination rates and vaccine hesitancy and the adoption of conspiracy theories by patients with severe mental illness in Türkiye. Ninety-eight outpatients with schizophrenia and 105 outpatients with bipolar disorder were included. A sociodemographical data form, a survey on beliefs and conspiracy theories on vaccines and Vaccine Hesitancy Scale were obtained. Vaccinated and unvaccinated groups were compared and evaluated separately for patients with schizophrenia and bipolar disorder. Sixty-one (62.24%) patients in the schizophrenia group and 86 (81.90%) patients in the bipolar disorder group were vaccinated, and the vaccination rate in the schizophrenia group was significantly lower (P = .002). There was no significant difference in terms of Vaccine Hesitancy Scale scores or adoption of any particular conspiracy theory between patients with schizophrenia and bipolar groups. However, vaccinated and unvaccinated patients of schizophrenia and bipolar disorder groups differed in terms of adopting beliefs and conspiracy theories on vaccines. Sixty-five (75.58%) of the vaccinated patients in the bipolar group agreed with the statement "vaccines are safe," while this rate was 8 (42.11%) in the unvaccinated patients (P = .004). In the schizophrenia group, however, the main difference between the vaccinated and unvaccinated patients was adopting the beliefs that "vaccines have serious side effects" and "vaccines may cause homosexuality" (P = .0341 and P = .003, respectively). The vaccination status of patients with schizophrenia might be under the stronger influence of conspiracy theories and specialized mental health interventions may be needed to ensure vaccination in patients with schizophrenia.

Associations between major depressive and bipolar disorders and eating disorder, PTSD, and comorbid symptom severity in eating disorder patients.

Major depressive disorder (MDD) and bipolar disorder (BD) are commonly comorbid with eating disorders (EDs). However, there is limited data about the clinical features of such patients, especially their association with traumatic histories and PTSD, which occur commonly in patients admitted to residential treatment. Adults (≥18years, 91% female, n=2155) admitted to residential ED treatment were evaluated upon admission for DSM-5 defined MDD and BD. Patients were divided into three groups based on an admission diagnosis of no mood disorder (NMD), MDD, and BD (types I and II) and compared on a number of demographic variables, clinical features and assessments. Mood disorders occurred in 76.4% of participants. There were statistically significant differences across groups in most measures with the BD group showing higher rates and doses of traumatic events; higher current PTSD; higher BMIs; higher severity of ED, depression and state-trait anxiety symptoms; worse quality of life; and higher rates of substance use disorders. Similarly, the MDD group had higher rates than the NMD group on most measures. These findings have important implications for prevention, treatment and long-term follow-up and highlight the need for early trauma-focused treatment of ED patients with comorbid mood disorders and PTSD.

Brand image design on consumer bipolar disorder based on cognitive psychology

BackgroundBrand image design starts with sensory stimulation. Consumers experience the brand image, recognize the brand, and purchase goods through their senses, which is a comprehensive experience. Eliminating psychological barriers requires starting from an emotional perspective, as brand emotionalization often occurs from the beginning of user contact, and is conveyed through the senses to establish a “sensory” level emotional experience. This study utilizes cognitive psychology to analyze consumers’ bidirectional emotional barriers and establish a positive and emotional brand image.Subjects and Methods This study uses SWOT analysis and semantic difference analysis methods. In terms of graphics, colors, and fonts proposed by a certain brand, eye tracking experiments will be conducted to collect images. 10 samples that meet the standards will be selected for redesign, and 4 of them will be evaluated through a questionnaire survey. SPSS23.0 statistical software will be used for statistical analysis to compare the significant differences in the results, and select the design scheme that best meets the emotional needs of consumers with bipolar disorder.Results This brand image design based on cognitive psychology has analyzed the emotional characteristics and aesthetic experience of depressed consumers, and the sensory needs of patients with bipolar disorder are more moderate and smooth sensory elements.ConclusionsThis study utilizes a multi-sensory participation in brand image design and sensory interaction design mechanism, focusing on consumers themselves, allowing bipolar disorder groups to fully experience brand information and create a pleasant experience, and integrate into society.AcknowledgementGeneral research projects of Pass College of Chongqing Technology and Business University in 2020 (No. KY202010).

Intersections of phenomenology, voice beliefs and distress in bipolar disorder: a comparison with schizophrenia.

Auditory verbal hallucinations (AVH), or voice-hearing, can be a prominent symptom during fluctuating mood states in bipolar disorder (BD). The current study aimed to: (i) compare AVH-related distress in BD relative to schizophrenia (SCZ), (ii) examine correlations between phenomenology and voice beliefs across each group, and (iii) explore how voice beliefs may uniquely contribute to distress in BD and SCZ. Participants were recruited from two international sites in Australia (BD=31; SCZ=50) and the UK (BD=17). Basic demographic-clinical information was collected, and mood symptoms were assessed. To document AVH characteristics, a 4-factor model of the Psychotic Symptoms Rating Scale and the Beliefs about Voices Questionnaire-Revised were used. Statistical analyses consisted of group-wise comparisons, Pearson's correlations and multiple hierarchical regressions. It was found that AVH-related distress was not significantly higher in BD than SCZ, but those with BD made significantly more internal attributions for their voices. In the BD group, AVH-related distress was significantly positively correlated with malevolence, omnipotence and resistance, However, only resistance, alongside mania and depressive symptoms, significantly contributed to AVH-related distress in BD. Our findings have several clinical implications, including identification of voice resistance as a potential therapeutic target to prioritise in BD. Factoring in the influence of mood symptoms on AVH-related distress as well as adopting more acceptance-oriented therapies may also be of benefit.

Self-stigma and coping in youth with schizophrenia and bipolar disorder: a comparative study

BackgroundSelf-stigma develops when people with mental disorders start to accept and apply the stigma that the wider public has towards these disorders. People suffering from mental disorders are one of the most groups prone to stigmatization others, making them more likely to experience internalized stigma. Studies done in Europe found that people with schizophrenia had greater internalized stigma than those with mood disorders. Self-stigma has been linked negatively to the individual’s self-esteem, coping, and other outcomes. The aim of this research was to compare young patients with bipolar disorder to those with schizophrenia as regards self-stigma and various coping mechanisms. Additionally, this study sought to evaluate the association between coping mechanisms and self-stigma in young people with schizophrenia and those with bipolar disorder. The ISMI scale and the BRIEF-COPE inventory were used to assess self-stigma and coping strategies respectively.ResultsThe mean ISMI total score was significantly higher in the schizophrenia group than in the bipolar disorder group (p < 0.001). The latter group showed a statistically significant higher mean total adaptive score than the schizophrenia group (p = 0.03). A significant positive correlation was found between the total maladaptive score of the BRIEF-COPE inventory and the ISMI scale total score (p < 0.001) in both groups.ConclusionsYouth with schizophrenia experience more self-stigma than those with bipolar disorder, with the former using more maladaptive coping styles. Self-stigma is strongly linked to maladaptive coping in both schizophrenia and bipolar disorder.

Frontostriatal circuitry and the tryptophan kynurenine pathway in major psychiatric disorders.

An imbalance of the tryptophan kynurenine pathway (KP) commonly occurs in psychiatric disorders, though the neurocognitive and network-level effects of this aberration are unclear. In this study, we examined the connection between dysfunction in the frontostriatal brain circuits, imbalances in the tryptophan kynurenine pathway (KP), and neurocognition in major psychiatric disorders. Forty first-episode medication-naive patients with schizophrenia (SCZ), fifty patients with bipolar disorder (BD), fifty patients with major depressive disorder (MDD), and forty-two healthy controls underwent resting-state functional magnetic resonance imaging. Plasma levels of KP metabolites were measured, and neurocognitive function was evaluated. Frontostriatal connectivity and KP metabolites were compared between groups while controlling for demographic and clinical characteristics. Canonical correlation analyses were conducted to explore multidimensional relationships between frontostriatal circuits-KP and KP-cognitive features. Patient groups shared hypoconnectivity between bilateral ventrolateral prefrontal cortex (vlPFC) and left insula, with disorder-specific dysconnectivity in SCZ related to PFC, left dorsal striatum hypoconnectivity. The BD group had higher anthranilic acid and lower xanthurenic acid levels than the other groups. KP metabolites and ratios related to disrupted frontostriatal dysconnectivity in a transdiagnostic manner. The SCZ group and MDD group separately had high-dimensional associations between KP metabolites and cognitive measures. The findings suggest that KP may influence cognitive performance across psychiatric conditions via frontostriatal dysfunction.

Association of polygenic risk for bipolar disorder with resting-state network functional connectivity in youth with and without bipolar disorder

Little is known regarding the polygenic underpinnings of anomalous resting-state functional connectivity (rsFC) in youth bipolar disorder (BD). The current study examined the association of polygenic risk for BD (BD-PRS) with whole-brain rsFC at the large-scale network level in youth with and without BD. 99 youth of European ancestry (56 BD, 43 healthy controls [HC]), ages 13–20 years, completed resting-state fMRI scans. BD-PRS was calculated using summary statistics from the latest adult BD genome-wide association study. Data-driven independent component analyses of the resting-state fMRI data were implemented to examine the association of BD-PRS with rsFC in the overall sample, and separately in BD and HC. In the overall sample, higher BD-PRS was associated with lower rsFC of the salience network and higher rsFC of the frontoparietal network with frontal and parietal regions. Within the BD group, higher BD-PRS was associated with higher rsFC of the default mode network with orbitofrontal cortex, and altered rsFC of the visual network with frontal and occipital regions. Within the HC group, higher BD-PRS was associated with altered rsFC of the frontoparietal network with frontal, temporal and occipital regions. In conclusion, the current study found that BD-PRS generated based on adult genetic data was associated with altered rsFC patterns of brain networks in youth. Our findings support the usefulness of BD-PRS to investigate genetically influenced neuroimaging markers of vulnerability to BD, which can be observed in youth with BD early in their course of illness as well as in healthy youth.