Symptoms In Bipolar Disorder Patients Research Articles

Lower serum insulin-like growth factor 2 level in patients with bipolar disorder is associated with the severity of manic symptoms during manic episodes.

Accumulating evidence has indicated that neurodevelopmental defects may underlie the pathophysiology of bipolar disorder (BD). Insulin-like growth factors (IGFs) are a family of neurotrophic factors that are essential for the survival and development of neurons. The present study aims to investigate whether IGF-2 signaling is implicated in the pathophysiological processes of BD. 50 healthy controls and 78 patients with BD, including 23 patients who diagnosed acute depressive episode and 55 patients who diagnosed acute manic episode, were recruited in this study. The 17-item Hamilton Depression Rating Scale (HAMD-17) and the Young Mania Rating Scale (YMRS) were used to assess the severity of the depressive and manic symptoms, respectively. The serum IGF-2 level was determined by an enzyme-linked immunosorbent assay (ELISA). The Kolmogorov-Smirnov and Mann-Whitney U tests were used for between-group comparisons and spearman analysis was used to analyze correlations. Patients with BD had lower serum IGF-2 levels (66.08 ± 21.22 ng/ml) when compared to healthy controls (88.72 ± 31.55 ng/ml). BD patients were divided into manic episode and depressive episode subgroups. We found that serum IGF-2 levels were reduced in both the mania and depression subgroups (mania: 67.19 ± 21.52 ng/ml, depression: 63.43 ± 20.67 ng/ml; P < 0.001), while no significant difference was observed between two groups (P > 0.05). Spearman correlation analyses revealed that the levels of serum IGF-2 were negatively correlated with the YMRS scores in BD patients (r = -0.522, P < 0.001). Furthermore, IGF-2 was found to be an independent contributor to the severity of symptoms in patients with manic episodes (B = -0.610, t = -5.299, P < 0.001). Lower serum IGF-2 levels were found in BD patients and correlated with the severity of the manic symptoms in these patients during manic episodes. These results suggest that reduced IGF-2 levels might be involved in the pathophysiology of BD, and serum IGF-2 could be a peripheral biomarker for the evaluation of the severity of manic symptoms in BD patients.

The Relationship Among Seasonality, Night Eating, and Chronotype in Bipolar Disorder: Exploring the Mediating Role of Sleep Quality.

The purpose of the study was to explore the association among chronotype, seasonality, sleep quality, and night eating syndrome (NES) among patients with bipolar disorder (BD) and the mediating role of sleep quality in this relationship. Ninety-two individuals with BD type 1 who had been euthymic for at least 8 weeks and 87 healthy controls were included. In addition to sociodemographic/clinical data, chronotype, seasonality, sleep quality, and NES were evaluated using the Morningness-Eveningness Questionnaire (MEQ), Seasonal Pattern Assessment Questionnaire, Pittsburgh Sleep Quality Index, and Night Eating Questionnaire. The prevalence of NES (17.4%) was higher among BD than the controls. BD patients with NES had poorer sleep quality, greater seasonality, and lower MEQ scores. Chronotype had an indirect effect that was partially mediated by sleep quality on night eating symptoms in BD patients, in addition to a direct effect. Seasonality was found to have a direct effect on night eating symptoms. Therapeutic interventions that target both sleep and circadian disruption should be implemented when addressing NES in patients with BD.

Beneficial effect of digoxin-specific Fab fragments in bipolar disorder- a preliminary study

A vast amount of experimental data supports the notion that Na+, K+-ATPase and endogenous cardiac steroids (ECS) such as digoxin and ouabain are involved in bipolar disorders. The aim of the study was to examine the possible beneficial effect of Digoxin-specific antibody Fab fragments Digibind, in bipolar disorder (BD) patients. In a pilot, open-label study without a control group, BD inpatient subjects received a single dose of Digibind, injected intravenously. During the 72 hrs following the intervention. the response to Digibind was measured using the Montgomery-Asberg Depression Rating Scale (MADRS). A total 6 patients with a moderate to severe bipolar depressive episode (MADRS 30.3, 24–38) participated in the study. We found a significant clinical improvement at all time points after Digibind administration, manifested by a maximal decrease in the MADRS score of 8.3 points at 24 hrs, followed by a gradual rebound to baseline scores. No control group was included, treatment was open-label, and only 6 patients were studied. This preliminary study showed that a one-time injection of Digibind resulted in a transient significant beneficial effect on depression symptoms in BD patients.

Segregation, integration and balance in resting-state brain functional networks associated with bipolar disorder symptoms.

Bipolar disorder (BD) is a serious mental disorder involving widespread abnormal interactions between brain regions, and it is believed to be associated with imbalanced functions in the brain. However, how this brain imbalance underlies distinct BD symptoms remains poorly understood. Here, we used a nested-spectral partition (NSP) method to study the segregation, integration, and balance in resting-state brain functional networks in BD patients and healthy controls (HCs). We first confirmed that there was a high deviation in the brain functional network toward more segregation in BD patients than in HCs and that the limbic system had the largest alteration. Second, we demonstrated a network balance of segregation and integration that corresponded to lower anxiety in BD patients but was not related to other symptoms. Subsequently, based on a machine-learning approach, we identified different system-level mechanisms underlying distinct BD symptoms and found that the features related to the brain network balance could predict BD symptoms better than graph theory analyses. Finally, we studied attention-deficit/hyperactivity disorder (ADHD) symptoms in BD patients and identified specific patterns that distinctly predicted ADHD and BD scores, as well as their shared common domains. Our findings supported an association of brain imbalance with anxiety symptom in BD patients and provided a potential network signature for diagnosing BD. These results contribute to further understanding the neuropathology of BD and to screening ADHD in BD patients.

Altered Metabolomics in Bipolar Depression With Gastrointestinal Symptoms.

ObjectiveAlthough gastrointestinal (GI) symptoms are very common in patients with bipolar disorder (BD), Few studies have researched the pathomechanism behind these symptoms. In the present study, we aim at elucidate the pathomechanism of GI symptoms in BD through metabolomic analysis.MethodBD patients were recruited from Shanxi Bethune Hospital that divided into two groups, each group assessed with the 24-item Hamilton Depression Rating Scale (HAMD-24) according to the presence or absence of GI symptoms. Healthy controls were recruited from the medical examination center of the same hospital. Differential metabolites were identified and further analyzed using Metabo Analyst 3.0 to identify associated metabolic pathways.ResultsThere were significantly higher HAMD-24 scores in the GI symptoms group than that of non-GI symptoms group (p = 0.007). Based on metabolomic analysis results, we found that the common disturbances metabolic pathway of both two patients groups was ketone body metabolism, and the unique disturbances metabolic pathways of BD with GI symptoms were fatty acid biosynthesis and tyrosine metabolism, and these changes were independent of dietary habits.ConclusionBD patients with GI symptoms exhibited disturbances in fatty acid and tyrosine metabolism, perhaps suggesting that the GI symptoms in BD patients are related to disturbances of the gut microbiome. Both groups of patients jointly exhibit disturbances of ketone body metabolism, which may serve as a biomarker for the pathogenesis of BD patients.

Frequency of psychiatric comorbid symptoms in bipolar disorder patients in remission.

Introduction:Psychiatric comorbidity has been detected in one-third of bipolar patients. The illness itself may be a precipitating factor for developing substance use and anxiety disorders. Comorbid anxiety disorders with bipolar disorder (BD) are associated with decreased chances of recovery, poorer role functioning, and quality of life, and greater likelihood of suicide attempts. Hence, identifying comorbid symptoms in remitting patients has important preventive and therapeutic implications.Aims:The aim of the study was to estimate the frequency of psychiatric comorbid symptoms in patients of bipolar affective disorder in remission and to identify its relationship with sociodemographic variables.Methodology:This is a cross-sectional study conducted in Father Muller Medical College and Hospital, Mangalore (April 2019–July 2019), which included 90 patients aged 18–50 years with BD, manic, or depressive episodes in remission for 8 weeks who were evaluated using mini international neuropsychiatric interview plus, Hamilton rating scale for depression, and young mania rating scale. Sociodemographic details were assessed by a semi-structured pro forma. The data were analyzed using frequency, Chi-square test, and t-test.Results:Most common psychiatry comorbid symptoms seen in BD were found to be drug dependence/abuse (n = 31), second most common being alcohol dependence/abuse (n = 21), followed by suicidality (n = 8), antisocial personality, social phobia, panic disorder, and agoraphobia. Significance was found for suicidality, agoraphobia, and social phobia if the last episode was depressive and for suicidality if index episode was depressive and if age of onset was >40 years.Conclusion:Psychiatric comorbidities in BD may worsen the course and prognosis of the disorder and hence, clinicians must maintain a high index of suspicion for them. Furthermore, comorbidities may need to be identified and appropriate interventions employed to prevent iatrogenic complications.

The association of childhood trauma, lifetime stressful events and general psychopathological symptoms in euthymic bipolar patients and healthy subjects

BackgroundPsychopathological symptoms during euthymia in Bipolar Disorder (BD) affect quality of life and predispose to the occurrence of new acute episodes, however only few studies investigated potential risk-factors. This study aims to explore the association between childhood trauma (CT), lifetime stressful events (SLEs) and psychopathological symptoms in BD patients during euthymia and controls (HC). MethodsA total of 261 participants (93 euthymic patients with BD, 168 HC) were enrolled. Generalized linear models and multiple logistic models were used to assess the association among the Symptom Check List-90-R (SCL-90-R), the Infancy Trauma Interview, the Paykel Life Events Scale. ResultsThe rate of participants reporting CT was higher in BD (n=47; 53%) than HC (n=43; 30%) (p=0.001). The experience of neglect was strongly related to BD (OR 6.5; p=0.003). CT was associated to higher scores on the SCL-90-R subscales (all the subscales except Phobia). No effects of the interaction between CT and diagnosis were found on SCL-90-R. Finally, there was a main effect of CT on lifetime SLEs (p<.001), that was not associated with diagnosis (p=0.833), nor with the interaction between CT and diagnosis (p=0.624). LimitationsThe cross-sectional design does not allow causal inferences; the exclusion of subjects reporting medical or psychiatric comorbidity limits generalizability. ConclusionsCT was associated both to psychopathological symptoms during euthymia and the lifetime SLEs, thus it may represent a vulnerability factor influencing the course of BD. Overall, these data contribute to overcome the limited evidences documenting the influence of environmental factors on euthymic phase in BD.

Odour identification impairment is a trait but not a disease-specific marker for bipolar disorders: Comparisons of bipolar disorder with different episodes, major depressive disorder and schizophrenia.

Olfactory deficits have been reported in bipolar disorder, but this finding is controversial. This study investigated whether olfactory deficit can serve as a specific marker for bipolar disorder by comparing olfactory function in different mood episodes of bipolar disorder. We also compared olfactory function in bipolar disorder and other mental disorders - namely, major depressive disorder and schizophrenia. The study consisted of two experiments. Experiment 1 enrolled 175 bipolar disorder patients (70 depressed subgroup, 70 manic subgroup and 35 euthymic subgroup) and 47 controls. Experiment 2 enrolled the participants from Experiment 1, along with 85 major depressive disorder and 90 schizophrenia patients. The Sniffin' Sticks test was used to evaluate odour identification ability and odour threshold (as a measure of odour sensitivity). The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to assess depressive symptoms in all subjects and manic symptoms in bipolar disorder patients, respectively. We also used the Positive and Negative Syndrome Scale to assess clinical symptoms in schizophrenia patients. All three bipolar disorder patient subgroups (depressed, manic and euthymic subgroup) showed reduced odour identification ability compared to controls; however, only patients in the acute phase of a mood episode (depressed, and manic subgroup) showed impaired odour sensitivity. Clinical symptoms were negatively correlated with odour sensitivity but not odour identification ability. Bipolar disorder and major depressive disorder patients showed less odour identification and sensitivity impairment than schizophrenia patients. Odour sensitivity is a potential dopaminergic marker for distinguishing between bipolar disorder patients in acute phase vs remission, while odour identification is a trait but a nonspecific marker of bipolar disorder.

Dissociative symptoms as measured by the Cambridge Depersonalization Scale in patients with a bipolar disorder

BackgroundThe Cambridge Depersonalization Scale (CDS) characterizes the quality, frequency, and duration of dissociative symptoms. While the psychometric properties of the CDS have been evaluated in primary dissociative disorder, this has been insufficiently addressed among other psychiatric patient groups such as patients with a bipolar disorder (BD). MethodsOutpatients with variable mood (n = 73) responded to a survey that assessed dissociative symptoms and other characteristics. We used factor analysis and McDonald's omega to evaluate psychometric properties of the CDS, and correlations with other characteristics. ResultsPreviously suggested multifactorial models of the CDS were not supported, but the single-dimensional model fit both dichotomized (p = 0.31, CFI = 0.99, RMSEA = 0.02, ECV 70%) and trichotomized CDS responses (p = 0.06, CFI = 0.96, RMSEA = 0.04, ECV 47%). The CDS showed high internal consistency (ω = 0.96). CDS factor scores correlated with symptom severity on the Quick Inventory for Depressive Symptoms (QIDS-SR-16) (ρ = 0.59), the Social Phobia Inventory (ρ = 0.52), the American Association of Psychiatry Severity measure for Panic Disorders (ρ = 0.46), the Childhood Trauma Questionnaire (ρ = 0.44), and the Trauma Screening Questionnaire (ρ = 0.53). Two abbreviated versions of the CDS, retaining the best 14 or 7 items were proposed. LimitationsThe sample size remained moderate. ConclusionsThe CDS is a psychometrically sound, unidimensional measure with clinical impact to detect and characterize dissociative symptoms in BD patients. Establishing the reliability and validity of the abbreviated scales for screening necessitates further study.

Evaluation of the relationship between separation anxiety and functionality in patients with bipolar disorder

Objective: Our study was carried out to investigate the functional status of separation anxiety symptoms in bipolar disorder patients. Methods: A total of 104 patients, in the 18-65 age group, who were followed with bipolar disorder diagnosis at psychiatry policlinic of Derince Training and Research Hospital, were included into our study between the dates of September 2016 and May 2017. Interview form was used in collection of data along with the Separation Anxiety Symptom Inventory, Adult Separation Anxiety Questionnaire, Bipolar Disorder Functioning Questionnaire which were subjected to validity and reliability analysis previously. Data were evaluated with independent t test, Kruskal Wallis, Mann Whitney U, ANOVA and Pearson correlation tests. Results: In the study, %67.3 of the cases with Separation Anxiety Symptom Inventory score and %66.3 with Adult Separation Anxiety Questionnaire score were found high. There was a statistically significant negative correlation between the total scores of Separation Anxiety Symptom Inventory and Bipolar Disorder Functioning Questionnaire. There was a statistically significant negative correlation between the total scores of Adult Separation Anxiety Questionnaire and Bipolar Disorder Func-tioning Questionnaire and mental functionality, sexual functionality, domestic relations subscales of Bipolar Disorder Functioning Questionnaire. Conclusion: Our study found that anxiety symptoms in childhood or adulthood in bipolar disorder patients negatively affected many areas of functionality.

The COMT Val158Met Polymorphism Is Associated With Response to Add-on Dextromethorphan Treatment in Bipolar Disorder.

We previously conducted a randomized, double-blind, controlled, 12-week study evaluating the effect of add-on dextromethorphan (DM), a noncompetitive N-methyl-D-aspartate receptor antagonist, on patients with bipolar disorder (BD) treated using valproate (VPA), which showed negative clinical differences. The genetic variation between each individual may be responsible for interindividual differences. The catechol-O-methyltransferase (COMT) gene has been a candidate gene for BD. In the current study, we investigated whether the COMT Val158Met polymorphism predicts treatment response to VPA + add-on DM and to VPA + placebo. Patients with BD (n = 309) undergoing regular VPA treatments were randomly assigned to groups given either add-on DM (30 mg/d) (n = 102), DM (60 mg/d) (n = 101), or placebo (n = 106) for 12 weeks. The Hamilton Depression Rating Scale and Young Mania Rating Scale were used to evaluate clinical response during weeks 0, 1, 2, 4, 8, and 12. The genotypes of the COMT Val158Met polymorphism were determined using polymerase chain reaction plus restriction fragment length polymorphism analysis. To adjust for within-subject dependence over repeated assessments, multiple linear regression with generalized estimating equation methods was used. When stratified by the COMT Val158Met genotypes, significantly greater decreases in Hamilton Depression Rating Scale scores were found in the VPA + DM (30 mg/d) group in patients with the Val/Met genotype (P = 0.008). We conclude that the COMT Val158Met polymorphism may influence responses to DM (30 mg/d) by decreasing depressive symptoms in BD patients.

Pattern of Obsessive Compulsive Symptoms among Patients with Bipolar-I Disorder

Background: Clinicians have observed the occurrence of obsessive and/or compulsive symptoms within the course of bipolar disorder. However the pattern of their occurrence is not clearly delineated. This study aimed to explore this pattern. Method: A cross sectional study. All patients were assessed by the Structured Clinical Interview for DSM-IV (SCID I) to diagnose bipolar disorder (BD) and comorbid obsessive compulsive (OC) symptoms. The symptom severity was assessed by Young Mania Rating Scale (YMRS), Beck Depression Inventory II (BDI-II), Yale-Brown Obsessions and compulsions Scale (Y-BOCS). Results: Sixty two patients were classified into two groups: BD comorbid with OC symptoms (BD-OC) and BD with no comorbidity (BD). High rates of OC symptoms in BD patients (38.7%) with higher educational level in the BDOC group, and higher rates of unemployment were noticed among patients of BD–OC group. The smoking was more prevalent in BD group than BD-OC group. The most common among BD-OC subjects were contamination, religious and aggressive obsessions and cleaning/washing and counting compulsions. Limitations: The prevalence rates are not to be generalized because of the small size of the sample. Most of the history was taken from the patients and their relatives depending on their memory. More experimental study designs about the effectiveness of different types of management strategies would be beneficial to the patients. Conclusion: Bipolar Patients with comorbid Obsessive and/or Compulsive symptoms showed higher educational levels, unemployment, greater functional impairment, and less smoking. Most common obsessions were contamination, religious and aggressive obsessions, cleaning and counting compulsions.

Obsessive compulsive symptoms in bipolar disorder patients: a comorbid disorder or a subtype of bipolar disorder?

SummaryOver the last decade increasing attention has been focused on individuals that simultaneously meet the criteria of two or more mental disorders. One of these comorbid conditions, comorbid bipolar disorder and obsessive compulsive disorder, is relatively common among patients with a primary diagnosis of bipolar disorder. But there is little research about the diagnosis and treatment of this comorbid condition, particularly in China. The available studies are primarily cross-sectional studies with small samples, so they are of limited use in understanding the etiology and course of this combined condition. A review of the limited literature suggests that this is a relatively severe, refractory subtype of bipolar disorder that only occasionally merits being considered a comorbid disorder. Larger prospective studies are needed to clarify the etiology, prognosis, and appropriate treatment for this comorbid condition.

P.1.k.017 Adult ADHD in a general psychiatric population

Neurotrophic factors regulate the survival and growth of neurons, and influence synaptic efficiency and plasticity. Several studies suggest the existence of a relationship between changes in neurotrophic levels and bipolar disorder (BD). The glial cell-line derived neurotrophic factor (GDNF) influences monoaminergic neurons and glial cells, but its role in BD patients is controversial. In order to elucidate it we evaluated plasma levels of GDNF in a sample of 70 BD patients (35 in mania and 35 in euthymia) and compared with 50 healthy controls matched for age, gender and educational levels. GDNF plasma levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients were assessed by a Mini-International Neuropsychiatric Interview (MINI-plus), Young Mania and Hamilton Depression Rating Scales. Plasma GDNF levels were significantly increased in BD patients in euthymia compared with BD patients in mania and healthy controls (p < 0.05). GDNF plasma levels were correlated with age (ρ = 0.30, p < 0.05) and negatively correlated with manic symptoms in BD patients (ρ = −0.54, p < 0.05). Our results provide evidence that peripheral levels of GDNF are related with different mood states in BD, reinforcing the involvement of neurotrophic factors in its physiopathology.

Decreased plasma neurotrophin-4/5 levels in bipolar disorder patients in mania

To evaluate two poorly explored neurotrophins (NT), NT-3 and NT-4/5, in bipolar disorder (BD). Forty patients with type I BD (18 in remission and 22 in mania) and 25 healthy controls matched for age, gender, and educational attainment were enrolled in this study. All subjects were assessed by the Mini-International Neuropsychiatric Interview; the Young Mania Rating Scale and the Hamilton Depression Rating Scale were used to evaluate severity of symptoms in BD patients. Plasma levels of NT-3 and NT-4/5 were measured by enzyme-linked immunosorbent assay (ELISA). BD patients in mania presented decreased NT-4/5 plasma levels in comparison with controls (p < 0.05). There were no significant differences in NT-3 plasma levels between BD patients and controls. These findings corroborate the view that neurotrophin dysfunction is associated with mood states in patients with BD.

Verbal episodic memory deficits in remitted bipolar patients: A combined behavioural and fMRI study

BackgroundEpisodic memory deficits affect the majority of patients with bipolar disorder (BD). AimsThe study investigates episodic memory performance through different approaches, including behavioural measures, physiological parameters, and the underlying functional activation patterns with functional neuroimaging (fMRI). Methods26 Remitted BD patients and a matched group of healthy controls underwent a verbal episodic memory test together with monitored autonomic response, psychopathological ratings and functional magnetic resonance imaging (fMRI) during the verbal episodic memory test. ResultsCompared to healthy controls, BD patients performed significantly worse during the episodic memory task. The results further indicate that verbal episodic memory deficits in BD are associated with abnormal functional activity patterns in frontal, occipital and limbic regions, and an increase in stress parameters. LimitationsWe aimed to minimise sample heterogeneity by setting clear criteria for remission, based on the scores of a depression (BDI II) and mania scale (BRMAS) and on the DSM IV criteria. However, our patients were not symptom-free and scored higher on BDI II scores than the control group. ConclusionsThe results are of interest for the treatment of cognitive symptoms in BD patients, as persistent cognitive impairment may hamper full rehabilitation.

Associations between depression severity and purinergic receptor P2RX7 gene polymorphisms

BackgroundMajor depressive disorder (MDD) and bipolar disorder (BPD) have significant genetic predisposition. The P2RX7 gene (coding for P2X7 purinergic receptor) has been suggested as a susceptibility gene for both MDD and BPD. In the current study the genetic effects of rs2230912 (Gln460Arg) and rs1653625 (located in the 3′ untranslated region of the P2RX7 gene) were explored in mood disorders. MethodsGenotype frequencies were established in 315 patients (195 with MDD and 120 with BPD diagnosis) and in 373 controls. Depression severity was assessed by the clinician-rated Montgomery–Åsberg Depression Rating Scale (MADRS) and by the self-report Hospital Anxiety and Depression Scale (HADS). ResultsIn the case-control analysis we did not find any significant differences between genotype frequencies of either BPD or MDD cases and controls. However, BPD patients carrying at least one rs2230912G-allele scored higher on both MADRS and HADS-depression scale (nominal p-value was 0.028 and 0.003, respectively). The rs1653625AA genotype was also associated with higher depression scores in the BPD group (nominal p-value of MADRS: 0.019, HADS-depression: 0.017). After correction for multiple testing, the association between rs2230912 and HADS-depression score remained significant in the BPD group (p<0.006); this genetic effect explained 9% of the variance (partial η2=0.09). In the MDD group we did not find any significant genetic effect. LimitationsThe relatively small number of BPD patients warrants for a replication study. ConclusionsOur genetic association study supports the association between P2RX7 gene and severity of depressive symptoms in BPD patients.

Peripheral PDLIM5 expression in bipolar disorder and the effect of olanzapine administration

BackgroundOne of the genes suggested to play an important role in the pathophysiology of bipolar disorder (BPD) is PDLIM5, which encodes LIM domain protein. Our main objective was to examine the effect of olanzapine treatment on PDLIM5 mRNA expression in the peripheral blood leukocytes of BPD patients.MethodsWe measured the expression of PDLIM5 mRNA from 16 patients with BPD Type I after 0, 4, and 8 weeks of treatment with olanzapine using quantitative real-time PCR. The Young Mania Rating Scale was used to evaluate the severity of manic symptoms in BPD patients. We also compared PDLIM5 mRNA expression in treatment-naïve BPD patients with that in healthy control subjects.ResultsNo significant difference was found in PDLIM5 mRNA expression between patients before olanzapine treatment and following 4 and 8 weeks of treatment (p>0.05). Although we observed a significant reduction in the severity of manic symptoms in all BPD patients (p<0.05), the effectiveness of the medication did not significantly correlate with the expression of PDLIM5 mRNA (p>0.05). Interestingly, PDLIM5 mRNA expression differed significantly between treatment-naïve BPD patients and healthy control subjects (p=0.002).ConclusionPDLIM5 mRNA expression did not appear to be a reflection of the efficacy of olanzapine in reducing the manic symptoms of BPD. The significant difference in expression of PDLIM5 mRNA in the peripheral blood leukocytes of treatment-naïve BPD patients versus that of healthy control subjects, however, suggests that it may be a good biological marker for BPD.

Circulating levels of GDNF in bipolar disorder

Neurotrophic factors regulate the survival and growth of neurons, and influence synaptic efficiency and plasticity. Several studies suggest the existence of a relationship between changes in neurotrophic levels and bipolar disorder (BD). The glial cell-line derived neurotrophic factor (GDNF) influences monoaminergic neurons and glial cells, but its role in BD patients is controversial. In order to elucidate it we evaluated plasma levels of GDNF in a sample of 70 BD patients (35 in mania and 35 in euthymia) and compared with 50 healthy controls matched for age, gender and educational levels. GDNF plasma levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients were assessed by a Mini-International Neuropsychiatric Interview (MINI-plus), Young Mania and Hamilton Depression Rating Scales. Plasma GDNF levels were significantly increased in BD patients in euthymia compared with BD patients in mania and healthy controls (p<0.05). GDNF plasma levels were correlated with age (ρ=0.30, p<0.05) and negatively correlated with manic symptoms in BD patients (ρ=−0.54, p<0.05). Our results provide evidence that peripheral levels of GDNF are related with different mood states in BD, reinforcing the involvement of neurotrophic factors in its physiopathology.

Correlates of recovery of social functioning in types I and II bipolar disorder patients

Since bipolar disorder (BPD) patients are often functionally impaired, and factors associated with recovery from disability are largely unknown, we investigated demographic, clinical, and neurocognitive correlates of current social functional recovery in 65 stable participants diagnosed with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) type I ( n = 42) or II ( n = 23) BPD. Regaining highest previous levels of social functioning was rated with the Interpersonal Relationships Questionnaire. We also considered neuropsychological test findings as well as demographic and clinical information including mania and depression symptom-ratings. We examined factors associated with social recovery status using univariate analyses and then multiple logistic regression modeling. Of all subjects, 30 (46%) achieved current social functional recovery and 35 (54%) did not. Younger age ( P = 0.005) and lesser current depressive symptoms ( P = 0.02) were associated with social functional recovery, even after controlling for time since the last major mood episode, diagnostic type (II vs. I), co-morbid psychiatric illness, and executive functioning status. The findings are consistent with deleterious effects of even residual depressive symptoms in BPD patients.