17 results
Psychopathy and Depression: The moderating role of Psychopathic Personality Traits between Emotional Competence and Cognitive Functioning
- E. M. D. Schönthaler, K. Schwalsberger, B. Reininghaus, E. Z. Reininghaus, N. Dalkner
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S348-S349
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Psychopathic personality traits (PPT) are known to deteriorate emotional and cognitive functions, however, little is known about their role in depression. Nevertheless, depressive symptoms have also shown to be associated with emotional problems and worse cognitive functions and could thus also interact with PPT.
ObjectivesThis study aimed to set up an integrative model by examining the correlative relationships and moderating role of PPT in the association between emotional competence and cognitive functioning in individuals with depression.
MethodsData from 373 individuals diagnosed with depression (158 males, 215 females) were investigated. Subjects filled out questionnaires surveying PPT and emotional competences. Furthermore, a comprehensive neuropsychological test battery investigating the cognitive domains Attention/Psychomotor Speed, Executive Functions and Verbal Learning/Memory was administered.
ResultsCorrelation analyses revealed a significant positive association between emotional competence and overall cognitive functioning. Further, negative associations between emotional competence and the PPT “Blame Externalisation” and “Careless Nonplanfulness”, as well as positive associations with psychopathic “Social Potency” and “Stress Immunity” were found. Moderation analyses indicated a significant positive influence of psychopathic “Stress Immunity” and “Social Influence” on the relationship between emotional competence and cognitive parameters.
ConclusionsThe findings highlight the importance of considering PPT in further research on depression and reflect their impact in therapeutic settings.
Disclosure of InterestNone Declared
The impact of obesity and metabolic syndrome on clinical and cognitive parameters in bipolar disorder: Results from the BIPFAT/BIPLONG study
- N. Dalkner, A. Birner, S. Bengesser, S. Guggemos, F. Fellendorf, A. Häussl, M. Lenger, A. Maget, A. Painold, M. Platzer, R. Queissner, F. Schmiedhofer, E. Schönthaler, S. Smolle, T. Stross, A. Tmava-Berisha, E. Z. Reininghaus
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S576-S577
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Patients with bipolar disorder have a hig risk of becoming overweight and obese, associated with an increased risk of somatic diseases and premature mortality. The Austrian BIPFAT/BIPLONG study aims at investigating lipid metabolism, psychosocial functioning, and cognitive parameters in bipolar disorder (BD).
ObjectivesThe aim was to investigate to what extent overweight, obesity and metabolic syndrome (MetS) are associated with clinical symptoms (e.g. suicidality, depressive symptoms) and cognitive factors (attention, memory, executive function) in BD.
MethodsIn addition to anamnestic interview and psychological tests, all participants were tested with a neuropsychological test battery including the Trail Making Test A/B, the Stroop Color and Word Interference Test, the d2 Test of Attention Revised, Digit Span, Digit-Symbol-Test, and the California Verbal Learning Test. Additionally, body mass index (BMI) and variables defining MetS including waist circumference, serum triglycerides, high-density lipoprotein, blood pressure, and fasting glucose levels have been collected in DSM-5 diagnosed patients with BD and healthy controls.
ResultsIn our Austrian bipolar cohort (n=290), the median BMI was 27.9 (SD=5.9), 30.5 % of the patients were overweight (BMI = 25.5-29.9) and 24.6% of the patients were obese (BMI ≥ 30.0). In the control group (n=183), the median BMI was 24.5 (SD=4.8), 15.2% were overweight and 8.0% were obese. A sub-analysis in 215 patients showed that compared to overweight patients, normal weight patients showed more suicidal ideation in psychiatric history (χ2(2)=7.97, p=.019). In addition, there was a significant association between suicidal ideation and glucose (r=.15, p=.043) and cholesterol (r=−.17, p=.028). In another sub-analysis with 148 euthymic bipolar patients, we found a high prevalence of MetS in patients with BD (30.4% versus 15.4% in healthy controls) associated with impaired executive function compared to patients without MetS or healthy controls with and without MetS (p=.020). Clinical variables (illness duration, suicidality, number of affective episodes, medication, age of onset, and history of psychosis) did not relate to MetS in BD (p > .05). A longitudinal analysis in 52 patients (35 without MetS and 17 with MetS) did not find an association of MetS on the one-year trajectory of cognitive decline in BD. In contrast, high baseline BMI predicted a decrease in the patient’s performance in working memory in the 12-months observation period.
ConclusionsThe BIPFAT/BIPLONG study demonstrated a high prevalence of overweight, obesity and MetS in bipolar patients with adverse effects on cognitive function. Clinical variables such as suicidality were not related to the presence of obesity or MetS. Clinical impact and further (unpublished) results will be presented.
Disclosure of InterestNone Declared
The use of new technology in prevention and treatment of psychiatric diseases - preliminary results
- A. Häussl, F. Fellendorf, E. Fleischmann, S. Guggemos, E. Schönthaler, T. Stross, I. Zwigl, D. Albert, J. Mosbacher, K. Stix, S. Draxler, G. Lodron, T. Orgel, M. Pszeida, S. Russegger, M. Schneeberger, M. Uray, W. Weiss, M. Fellner, T. Fruhmann, R. Hartmann, P. Hauptmann, R. Pfiszter, G. Pötz, U. Prattner, N. Saran, S. Spat, E. Zweytik, T. Lutz, S. Lindner-Rabl, R. Roller-Wirnsberger, S. Schüssler, J. Zuschnegg, K. Ceron, M. Danilov, C. Grossegger, M. Macher, O. Sokolov, S. Egger-Lampl, B. Roszipal, L. Paletta, M. Lenger, N. Dalkner, E. Reininghaus
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S853-S854
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
The COVID-19 outbreak is a serious global public health issue with wide-ranging negative effects on people’s lives, which is reflected in steadily rising mental health problems. In order to appropriately respond to the increased occurrence of psychiatric illness, protect mental health and strengthen resilience it is necessary to include new technologies, such as extended reality (XR) or socially assistive robots (SAR) in not only psychiatric treatment but also in the prevention of psychiatric diseases. In this context, the use of new technologies offers innovative ways to strengthen resilience, self-efficacy and stress coping skills and plays an important role in improving psychological wellbeing.
ObjectivesPreliminary results from studies at the Clinical Department of Psychiatry and Psychotherapeutic Medicine in Graz, Austria, dealing with new technologies in psychiatry, show new options for psychiatric settings.
MethodsProject AMIGA: The aim of this study is to test the effectiveness of a cognitive training session, conducted with the SAR named Pepper. In this randomized controlled trial, the effectiveness of SAR on depressive symptoms and correlates is evaluated in a sample of 60 individuals with major depression. While the intervention group will receive cognitive training with the SAR Pepper, the control group will receive “treatment-as-usual” therapy with a common PC software. Participants will receive 30 minutes of training 2 times per week over a period of 3 weeks.
Project XRes4HEALTH: The aim of this study is to develop an XR resilience training to increase resilience and stress coping mechanisms in healthcare workers. A total of 40 people will be included. To test the effectiveness of the resilience training, 3 XR training sessions of 15 minutes each will be held. A pre-post measurement will test the effectiveness of the training on wellbeing and stress levels as well as the acceptance and satisfaction with the training.
Project AI-REFIT: The overall goal of this study is to explore key information to increase resilience in healthy individuals who are at increased risk for mental health problems. Through a usability study, the artificial intelligence-based prototype app of the resilience training will be tested for acceptance, usability, functionality, and efficiency. During the resilience training, participants are wearing a smartwatch which measures psychophysiological parameters. Conclusions about the success of the therapy can be drawn based on digital data acquisition.
ResultsNew technologies including XR and SAR support classical psychiatric treatment in the topics of resilience and cognitive training as an add-on therapy in times of reduced availability of healthcare workers.
ConclusionsThe rapid development of new technologies holds a lot of potential in the treatment of psychiatric disorders, which is why it is important to scientifically evaluate those innovative tools.
Disclosure of InterestNone Declared
Robot assisted treatment in psychiatry - fiction or reality?
- E. Z. Reininghaus, A. Häussl, I. Zwigl, S. Guggemos, F. T. Fellendorf, N. Dalkner
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S856
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
The evolution of technologies like artificial intelligence and robotics has already begun to shape the future of health care delivery and will have an undeniable impact on patient experiences over the next decades. In times of shortened human resources, especially in the field of health care settings, we should also consider robots as assistance for existing treatment settings. The use of robotic assisted surgery has already found its way into clinical practice and allows doctors to perform many types of complex procedures with more precision, flexibility and control. Nevertheless, to date, the use of robotics in the field of psychiatry is sparse, at least in European countries.
Socially assistive robots (SARs) are robotic technology platforms with audio, visual, and movement capabilities that are being developed to interact with individuals while also assisting them with their management of their well-being. Robots could support classic psychiatric treatment by training cognition and motivation as well as educating patients.
ObjectivesThe robot “Pepper” has found its home at the Medical University of Graz, Department of Psychiatry & Psychotherapeutic Medicine in Austria in summer 2022. It is friendly and positive, around 1,30m tall, can make conversations, learn people’s tastes, preferences, and habits to help personalize responses and better address needs. He can also offer games, make music and dance.
MethodsIn our ongoing studies we use the robot “Pepper” in the context of psychoeducational settings on different mental diseases, training of cognitive functions as well as motivational aspects in inpatients with psychiatric disorders. It can also react and suggest a break during the sessions if he has the impression that participants are stressed or overstrained with content. We collect personal feedback of the patients and associated employees in the hospital through the ongoing usability study, as well as perform a randomized controlled trial to test effects of cognitive and motivational training aspects in comparison to standardized treatment settings.
ResultsIt is time to apply new technologies in healthcare, especially in times when the staff is decreasing. Better integrating and expanding on the mental health implications of social robots will complement the ongoing drive in the field of psychology and psychiatry to better assist clients with supportive exercises and education, cognitive training, and an asynchronous care option.
ConclusionsAlthough the use of SARs in mental health research is not yet widespread, new robots and programming are constantly changing, adapting and expanding. There is an abundance of opportunity for growth, expansion, and exploration to triangulate SARs usability and efficacy as the next step in advancing this field. We should not be afraid of this new and expanding technology but come to use it as soon as possible as a support in psychiatric treatment. Let‘s make fiction become reality!
Disclosure of InterestNone Declared
Tryptophan metabolism in bipolar disorder
- F. Fellendorf, M. Platzer, A. Birner, R. Queissner, S. Bengesser, M. Lenger, A. Maget, A. Tmava-Berisha, N. Dalkner, D. Fuchs, J. Gostner, E. Reininghaus
-
- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, p. S110
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Immune mediated inflammatory processes are involved in the aetiopathogenesis of bipolar disorder (BD) and weight associated comorbidities. Tryptophan breakdown via indoleamine 2,3-dioxygenase-1 (IDO-1) along the kynurenine axis concomitant with a pro-inflammatory state was found more active in BD but also associated with overweight/obesity.
ObjectivesAims of our study were to investigate 1.) the tryptophan metabolism in BD compared to mentally healthy controls, 2.) differences in weight classes, 3.) in a longitudinal setting, dependent on the incidence of BD episodes and euthymia.
MethodsAt the Medical University Graz anthropometric and clinical data as well as peripheral tryptophan and kynurenine were assessed in serum samples of 226 individuals with BD and 142 controls. For 75 individuals with BD a longitudinal assessment with three samples was performed. Serum concentrations of tryptophan and kynurenine were determined by reverse-phase high-performance liquid chromatography. The kynurenine/tryptophan was used as a proxy for IDO-1 activity.
Resultsshowed a higher kynurenine/tryptophan ratio in BD compared to controls and in overweight compared to normal weight persons. Levels remained stable over time. In the longitudinal course, no differences were found between individuals who were constantly euthymic or not as well who had an illness episode or none.
ConclusionsFindings indicate that IDO-1 activity might constitute more a trait and not a state marker of BD. Accelerated tryptophan breakdown along the kynurenine axis may be further facilitated by overweight. This may increase the risk of accumulation of neurotoxic metabolites which impacts BD symptomatology, cognition, and somatic comorbidities.
DisclosureNo significant relationships.
Physical health profile and associated behaviour during the COVID-19 pandemic in patients with bipolar disorder
- J.D. Sperling, N. Dalkner, C. Berndt, E. Fleischmann, M. Ratzenhofer, J. Martini, A. Pfennig, M. Bauer, E. Reininghaus, M. Vinberg
-
- Journal:
- European Psychiatry / Volume 65 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 01 September 2022, pp. S403-S404
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioural, mental, and physical health, presumably with effects on patients with severe mental disorders.
ObjectivesThis study examines pandemic-related physical and mental health and (compensatory) behavioural changes, in patients with BD as compared to healthy control individuals.
MethodsPhysical and mental health and self-reported changes in daily structure and behaviour due to pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) from outpatient clinics in Germany, Austria, and Denmark in individuals with BD and a healthy control group.
ResultsThe present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rate of COVID-19 testing, had more worries concerning health and experienced more anxiety but less social distancing.
ConclusionsThe COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behaviour due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimising and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as COVID-19 pandemic.
DisclosureNo significant relationships.
Interplay between the Genetics of Personality Traits, severe Psychiatric Disorders, and COVID-19 Host Genetics in the Susceptibility to SARS-CoV-2 Infection - ADDENDUM
- Urs Heilbronner, Fabian Streit, Thomas Vogl, Fanny Senner, Sabrina K. Schaupp, Daniela Reich-Erkelenz, Sergi Papiol, Mojtaba Oraki Kohshour, Farahnaz Klöhn-Saghatolislam, Janos L. Kalman, Maria Heilbronner, Katrin Gade, Ashley L. Comes, Monika Budde, Till F. M. Andlauer, Heike Anderson-Schmidt, Kristina Adorjan, Til Stürmer, Adrian Loerbroks, Manfred Amelang, Eric Poisel, Jerome Foo, Stefanie Heilmann-Heimbach, Andreas J. Forstner, Franziska Degenhardt, Jörg Zimmermann, Jens Wiltfang, Martin von Hagen, Carsten Spitzer, Max Schmauss, Eva Reininghaus, Jens Reimer, Carsten Konrad, Georg Juckel, Fabian U. Lang, Markus Jäger, Christian Figge, Andreas J. Fallgatter, Detlef E. Dietrich, Udo Dannlowski, Bernhardt T. Baune, Volker Arolt, Ion-George Anghelescu, Markus M. Nöthen, Stephanie H. Witt, Ole A. Andreassen, Chi-Hua Chen, Peter Falkai, Marcella Rietschel, Thomas G. Schulze, Eva C. Schulte
-
- Journal:
- BJPsych Open / Volume 7 / Issue 6 / November 2021
- Published online by Cambridge University Press:
- 18 November 2021, e206
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
Interplay between the genetics of personality traits, severe psychiatric disorders and COVID-19 host genetics in the susceptibility to SARS-CoV-2 infection
- Urs Heilbronner, Fabian Streit, Thomas Vogl, Fanny Senner, Sabrina K. Schaupp, Daniela Reich-Erkelenz, Sergi Papiol, Mojtaba Oraki Kohshour, Farahnaz Klöhn-Saghatolislam, Janos L. Kalman, Maria Heilbronner, Katrin Gade, Ashley L. Comes, Monika Budde, Till F. M. Andlauer, Heike Anderson-Schmidt, Kristina Adorjan, Til Stürmer, Adrian Loerbroks, Manfred Amelang, Eric Poisel, Jerome Foo, Stefanie Heilmann-Heimbach, Andreas J. Forstner, Franziska Degenhardt, Jörg Zimmermann, Jens Wiltfang, Martin von Hagen, Carsten Spitzer, Max Schmauss, Eva Reininghaus, Jens Reimer, Carsten Konrad, Georg Juckel, Fabian U. Lang, Markus Jäger, Christian Figge, Andreas J. Fallgatter, Detlef E. Dietrich, Udo Dannlowski, Bernhardt T. Baune, Volker Arolt, Ion-George Anghelescu, Markus M. Nöthen, Stephanie H. Witt, Ole A. Andreassen, Chi-Hua Chen, Peter Falkai, Marcella Rietschel, Thomas G. Schulze, Eva C. Schulte
-
- Journal:
- BJPsych Open / Volume 7 / Issue 6 / November 2021
- Published online by Cambridge University Press:
- 07 October 2021, e188
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with its impact on our way of life, is affecting our experiences and mental health. Notably, individuals with mental disorders have been reported to have a higher risk of contracting SARS-CoV-2. Personality traits could represent an important determinant of preventative health behaviour and, therefore, the risk of contracting the virus.
AimsWe examined overlapping genetic underpinnings between major psychiatric disorders, personality traits and susceptibility to SARS-CoV-2 infection.
MethodLinkage disequilibrium score regression was used to explore the genetic correlations of coronavirus disease 2019 (COVID-19) susceptibility with psychiatric disorders and personality traits based on data from the largest available respective genome-wide association studies (GWAS). In two cohorts (the PsyCourse (n = 1346) and the HeiDE (n = 3266) study), polygenic risk scores were used to analyse if a genetic association between, psychiatric disorders, personality traits and COVID-19 susceptibility exists in individual-level data.
ResultsWe observed no significant genetic correlations of COVID-19 susceptibility with psychiatric disorders. For personality traits, there was a significant genetic correlation for COVID-19 susceptibility with extraversion (P = 1.47 × 10−5; genetic correlation 0.284). Yet, this was not reflected in individual-level data from the PsyCourse and HeiDE studies.
ConclusionsWe identified no significant correlation between genetic risk factors for severe psychiatric disorders and genetic risk for COVID-19 susceptibility. Among the personality traits, extraversion showed evidence for a positive genetic association with COVID-19 susceptibility, in one but not in another setting. Overall, these findings highlight a complex contribution of genetic and non-genetic components in the interaction between COVID-19 susceptibility and personality traits or mental disorders.
Characterisation of age and polarity at onset in bipolar disorder
- Janos L. Kalman, Loes M. Olde Loohuis, Annabel Vreeker, Andrew McQuillin, Eli A. Stahl, Douglas Ruderfer, Maria Grigoroiu-Serbanescu, Georgia Panagiotaropoulou, Stephan Ripke, Tim B. Bigdeli, Frederike Stein, Tina Meller, Susanne Meinert, Helena Pelin, Fabian Streit, Sergi Papiol, Mark J. Adams, Rolf Adolfsson, Kristina Adorjan, Ingrid Agartz, Sofie R. Aminoff, Heike Anderson-Schmidt, Ole A. Andreassen, Raffaella Ardau, Jean-Michel Aubry, Ceylan Balaban, Nicholas Bass, Bernhard T. Baune, Frank Bellivier, Antoni Benabarre, Susanne Bengesser, Wade H Berrettini, Marco P. Boks, Evelyn J. Bromet, Katharina Brosch, Monika Budde, William Byerley, Pablo Cervantes, Catina Chillotti, Sven Cichon, Scott R. Clark, Ashley L. Comes, Aiden Corvin, William Coryell, Nick Craddock, David W. Craig, Paul E. Croarkin, Cristiana Cruceanu, Piotr M. Czerski, Nina Dalkner, Udo Dannlowski, Franziska Degenhardt, Maria Del Zompo, J. Raymond DePaulo, Srdjan Djurovic, Howard J. Edenberg, Mariam Al Eissa, Torbjørn Elvsåshagen, Bruno Etain, Ayman H. Fanous, Frederike Fellendorf, Alessia Fiorentino, Andreas J. Forstner, Mark A. Frye, Janice M. Fullerton, Katrin Gade, Julie Garnham, Elliot Gershon, Michael Gill, Fernando S. Goes, Katherine Gordon-Smith, Paul Grof, Jose Guzman-Parra, Tim Hahn, Roland Hasler, Maria Heilbronner, Urs Heilbronner, Stephane Jamain, Esther Jimenez, Ian Jones, Lisa Jones, Lina Jonsson, Rene S. Kahn, John R. Kelsoe, James L. Kennedy, Tilo Kircher, George Kirov, Sarah Kittel-Schneider, Farah Klöhn-Saghatolislam, James A. Knowles, Thorsten M. Kranz, Trine Vik Lagerberg, Mikael Landen, William B. Lawson, Marion Leboyer, Qingqin S. Li, Mario Maj, Dolores Malaspina, Mirko Manchia, Fermin Mayoral, Susan L. McElroy, Melvin G. McInnis, Andrew M. McIntosh, Helena Medeiros, Ingrid Melle, Vihra Milanova, Philip B. Mitchell, Palmiero Monteleone, Alessio Maria Monteleone, Markus M. Nöthen, Tomas Novak, John I. Nurnberger, Niamh O'Brien, Kevin S. O'Connell, Claire O'Donovan, Michael C. O'Donovan, Nils Opel, Abigail Ortiz, Michael J. Owen, Erik Pålsson, Carlos Pato, Michele T. Pato, Joanna Pawlak, Julia-Katharina Pfarr, Claudia Pisanu, James B. Potash, Mark H Rapaport, Daniela Reich-Erkelenz, Andreas Reif, Eva Reininghaus, Jonathan Repple, Hélène Richard-Lepouriel, Marcella Rietschel, Kai Ringwald, Gloria Roberts, Guy Rouleau, Sabrina Schaupp, William A Scheftner, Simon Schmitt, Peter R. Schofield, K. Oliver Schubert, Eva C. Schulte, Barbara Schweizer, Fanny Senner, Giovanni Severino, Sally Sharp, Claire Slaney, Olav B. Smeland, Janet L. Sobell, Alessio Squassina, Pavla Stopkova, John Strauss, Alfonso Tortorella, Gustavo Turecki, Joanna Twarowska-Hauser, Marin Veldic, Eduard Vieta, John B. Vincent, Wei Xu, Clement C. Zai, Peter P. Zandi, Psychiatric Genomics Consortium (PGC) Bipolar Disorder Working Group, International Consortium on Lithium Genetics (ConLiGen), Colombia-US Cross Disorder Collaboration in Psychiatric Genetics, Arianna Di Florio, Jordan W. Smoller, Joanna M. Biernacka, Francis J. McMahon, Martin Alda, Bertram Müller-Myhsok, Nikolaos Koutsouleris, Peter Falkai, Nelson B. Freimer, Till F.M. Andlauer, Thomas G. Schulze, Roel A. Ophoff
-
- Journal:
- The British Journal of Psychiatry / Volume 219 / Issue 6 / December 2021
- Published online by Cambridge University Press:
- 25 August 2021, pp. 659-669
- Print publication:
- December 2021
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
AimsTo examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
MethodGenome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
ResultsEarlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
ConclusionsAAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Stress reactivity as a putative mechanism linking childhood trauma with clinical outcomes in individuals at ultra-high-risk for psychosis: Findings from the EU-GEI High Risk Study
- I. Paetzold, I. Myin-Germeys, A. Schick, B. Nelson, E. Velthorst, F. Schirmbeck, EU-GEI High Risk Study , J. van Os, C. Morgan, J. Hartmann, M. van der Gaag, L. de Haan, L. Valmaggia, P. McGuire, M. Kempton, U. Reininghaus
-
- Journal:
- Epidemiology and Psychiatric Sciences / Volume 30 / 2021
- Published online by Cambridge University Press:
- 28 May 2021, e40
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Aims
Childhood trauma is associated with an elevated risk for psychosis, but the psychological mechanisms involved remain largely unclear. This study aimed to investigate emotional and psychotic stress reactivity in daily life as a putative mechanism linking childhood trauma and clinical outcomes in individuals at ultra-high-risk (UHR) for psychosis.
MethodsExperience sampling methodology was used to measure momentary stress, affect and psychotic experiences in the daily life of N = 79 UHR individuals in the EU-GEI High Risk Study. The Childhood Trauma Questionnaire was used to assess self-reported childhood trauma. Clinical outcomes were assessed at baseline, 1- and 2-year follow-up.
ResultsThe association of stress with positive (β = −0.14, p = 0.010) and negative affect (β = 0.11, p = 0.020) was modified by transition status such that stress reactivity was greater in individuals who transitioned to psychosis. Moreover, the association of stress with negative affect (β = 0.06, p = 0.019) and psychotic experiences (β = 0.05, p = 0.037) was greater in individuals exposed to high v. low levels of childhood trauma. We also found evidence that decreased positive affect in response to stress was associated with reduced functioning at 1-year follow-up (B = 6.29, p = 0.034). In addition, there was evidence that the association of childhood trauma with poor functional outcomes was mediated by stress reactivity (e.g. indirect effect: B = −2.13, p = 0.026), but no evidence that stress reactivity mediated the association between childhood trauma and transition (e.g. indirect effect: B = 0.14, p = 0.506).
ConclusionsEmotional and psychotic stress reactivity may be potential mechanisms linking childhood trauma with clinical outcomes in UHR individuals.
Clinical Implications of White Matter Lesions in Overweight Male Individuals with Bipolar Disorder
- A. Birner, S. Seiler, N. Lackner, S. Bengesser, R. Queissner, M. Platzer, F. Fellendorf, L. Pirpamer, S. Ropele, C. Enzinger, H.P. Kapfhammer, B. Reininghaus, E. Reininghaus
-
- Journal:
- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Cerebral white matter lesions (WML) have been found in normal aging, vascular disease and several neuropsychiatric conditions. Correlations of volumetric measured WML with clinical parameters in men with Bipolar Disorder (BD) have been described in a currently submitted work of our study group. As we try to elucidate common pathways between obesity/metabolic syndrome and BD we reinvestgated our data in the context of obesity.
MethodsIn a cross-sectional study 100 euthymic individuals (52 male, 48 female) with BD were enrolled to undergo brain magnetic resonance imaging using 3T including a FLAIR sequence for volumetric assessment of WML-load using FSL-software. Additionally, clinical characteristics and psychometric measures including Structured Clinical Interview according to DSM-IV were evaluated. Partial correlation analysis (WML-load with lifetime number of manic/depressive episodes) were performed in 4 different groups (male normalweight, male overweight/obese, female normalweight, female overweight/obese)
ResultsIn overweight/obese men only (n=41), the number of manic/hypomanic episodes (r=0.85; p<0.001) as well as depressive episodes (r=0.55; p<0.001) correlated positively with WML-load.
ConclusionsWML-load strongly correlated with the number of manic episodes in overweight male BD patients, suggesting that overweight men might be more vulnerable to mania in the context of cerebral white matter changes.
EPA-0451 - Phenylalanine and Tyrosine Concentrations in Euthymic Bipolar Disorder
- E. Reininghaus, R.S. McIntyre, N. Lackner, S.A. Bengesser, A. Birner, F.T. Fellendorf, H.P. Kapfhammer, A. Meinitzer, S. Zelzer, S.J. Wallner-Liebmann, H. Mangge, D. Fuchs
-
- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
-
- Article
-
- You have access Access
- Export citation
-
Background:
Individuals with bipolar disorder (BD) are differentially affected by insulin resistance. Individuals without history of mental disorder with insulin resistance usually have high peripheral concentrations of phenylalanine (PHE) and tyrosine (TYR) together. Catecholamine dysfunction is described to be a state-dependend phenomen in patients suffering from BD. Catecholamines are synthesized from essential amino acids PHE and TYR which are biotransformed to dopamine and subsequently converted to nor/adrenaline. Amino acid dysregulation may be a possible mediator of insulin resistance in BD.
Patients/Methods:Peripheral PHE and TYR concentrations were investigated in euthymic adults with BD. Amino acid differences between normal and overweight individuals with BD were evaluated and outcomes were correlated with the measures of glucose homeostasis.
Results:Mean plasma PHE to TYR ratio (PHE/TYR) was at the upper limit of the normal range in the whole sample. Enrolled subjects with PHE/TYR beyond the limits of normal exhibited the highest number of prior affective episodes. Sex-specific differences were noted as overweight BD females showed different profiles than normal-weight women. In the overweight females, PHE and TYR concentrations were significantly higher compared to normal-weight women. Significant correlations were noticed between PHE, TYR and PHE/TYR with insulin/Homeostasis Model of Assessment (HOMA)-IR in the whole sample and the subgroup of BD women.
Conclusion:These significant differences in gender, amino acid pathways and in correlations with immune marker as well as insulin function have not been reported previously. Taken together, increased levels of PHE in BD should be considered when adjudicating diabetes risk especially in women.
Is the Molecular Clock Ticking Differently in Bipolar Disorder?
- S. Bengesser, N. Lackner, A. Birner, B. Reininghaus, U. Heilbronner, R. Fuchs, N. Allard, S. Wallner-Liebmann, A. Rieger, R. Queissner, K. Filic, F. Fellendorf, E. Petek, C. Windpassinger, C. Schörkhuber, C. Gigler, K. Gatkowsky, T. Macheiner, N. Kainzbauer, E. Reininghaus
-
- Journal:
- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Bipolar Disorder is a devastating disease with a genetic heritability. An orchestra of around 500 gene variants is leading to vulnerability.
One interesting candidate gene group are the socalled CLOCK GENES. The molecular 24h clock has several CLOCK GENES and the last gene ARNTL encodes for an activator of MAOA transcription and leads therefore to changes in neurotransmitter levels.
MethodsGenotyping of 150 paricipants with Bipolar Disorder and 78 healthy controls with the Illumina GWAS chip Omniexpress 1.1. Hypothesis driven extraction of ARNTL SNPs with the software PLINK. Statistical analysis with Chi square test with SPSS.
ResultsPatients with Bipolar Disorder differ significantly in ARNTL genotypes compared to healthy controls. Details are presented during the poster session.
DiscussionCircadian rhythms seem to play an important pathogenetic mechanism in Bipolar Disorder.
Food Craving in Bipolar Disorder
- N. Lackner, M. Platzer, F.T. Fellendorf, A. Rieger, C. Schörkhuber, R. Queissner, K. Gatkowsky, A. Birner, S.A. Bengesser, R. Unterweger, A. Painold, B. Reininghaus, E. Weiss, S.J. Wallner-Liebmann, H.P. Kapfhammer, E.Z. Reininghaus
-
- Journal:
- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
-
- Article
-
- You have access Access
- Export citation
-
Objectives
Food craving (FC) has been linked todepressive mood before. However, no study exists evaluating FC in a sample of bipolar disorder (BD).
AimsThis study aimed to determine the prevalence of FC in individuals with BD during euthymia.
MethodsFifty individuals with a BD diagnosis according to the DSM-IV guidelines were drawn from the dedicated outpatient center of the University Clinic of Psychiatry Graz. Data were compared with data from a healthy control sample (HC, n=50). All probands took part in the BIPFAT study exploring shared pathophysiological pathways of obesity and brain function in BD. Participants completed a comprehensive diagnostic battery (including the Food Craving Questionnaire by White et al. 2002) measuring anamnestic, anthropometric, and clinical data. We performed a MANCOVA controlling for key covariates including gender, age, body mass index, smoking, mood stabilizing medication, and lipid levels.
ResultsBD patients exhibited significantly more total food craving (F=6.10, p=.016) and more sweets craving than controls (F=6.38, p=.014). Additionally, levels of fat craving were higher by trend in the male patient group than in the male control group (F=3.15, p=.087).
ConclusionsA higher prevalence of FC in BD patients than in controls suggests that FC may be of clinical importance in BD. Potentially, FC plays a role in the development of obesity, a well-known risk factor for unfavorable course of illness in BD. Furthermore, the impact of dysfunctions in the serotonergic system and/or an altered activation of the hypothalamic-pituitary-adrenal axis in relationship to increased FC are critically discussed.
EPA-0444 – The Role of Staging in Bipolar Disorder - Associations with Overweight and Obesity
- N. Lackner, S. Bengesser, A. Birner, F. Fellendorf, R. Unterweger, S. Wallner-Liebmann, H.P. Kapfhammer, E. Reininghaus
-
- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
-
- Article
-
- You have access Access
- Export citation
-
Introduction:
Overweight and obesity are highly prevalent in bipolar disorder (BD), and have been observed to worsen treatment response and outcome. Moreover, a relationship between overweight/obesity and cognitive impairment has been reported previously. Clinical staging includes clinical features, data of biomarkers and cognition, and is related to global functioning in BD. Earlier stages of illness may be associated with a better prognosis and a higher treatment response.
Objectives:The present study aims to evaluate the relationship between clinical staging and overweight/obesity in euthymic BD individuals. Clinical staging was hypothesized to be associated with overweight/obesity, especially with indicators of abdominal obesity.
Methods:A cohort of 100 euthymic BD patients was recruited and anthropometric variables (including body mass index and waist/hip circumference) were measured. Body composition was evaluated with lipometry measurement, an exact calculation of the subcutaneous adipose tissue thickness. Clinical staging was done according to the staging model by Kapzinsky et al. For statistical analyses, partial correlations controlled for age were used.
Results:Findings show a positive correlation between staging and hip circumference r=.265, p<.05, and a tendeny towards significance between staging and total body fat: r=.183, p=.08).
Conclusions:As clinical outcome parameter, staging enables to unterstand the mechanisms underlying progression of BD and assists in treatment planning and prognosis. Based on the results we might suggest, that abdominal obesity is associated with a higher progression of BD accompanied with negative outcome characteristics. The data provide an updated quantification of the growing public health burden in BD.
Daily use of high-potency cannabis is associated with more positive symptoms in first-episode psychosis patients: the EU-GEI case–control study
- Diego Quattrone, Laura Ferraro, Giada Tripoli, Caterina La Cascia, Harriet Quigley, Andrea Quattrone, Hannah E. Jongsma, Simona Del Peschio, Giusy Gatto, EU-GEI group, Charlotte Gayer-Anderson, Peter B. Jones, James B. Kirkbride, Daniele La Barbera, Ilaria Tarricone, Domenico Berardi, Sarah Tosato, Antonio Lasalvia, Andrei Szöke, Celso Arango, Miquel Bernardo, Julio Bobes, Cristina Marta Del Ben, Paulo Rossi Menezes, Pierre-Michel Llorca, Jose Luis Santos, Julio Sanjuán, Andrea Tortelli, Eva Velthorst, Lieuwe de Haan, Bart P. F. Rutten, Michael T. Lynskey, Tom P. Freeman, Pak C. Sham, Alastair G. Cardno, Evangelos Vassos, Jim van Os, Craig Morgan, Ulrich Reininghaus, Cathryn M. Lewis, Robin M. Murray, Marta Di Forti
-
- Journal:
- Psychological Medicine / Volume 51 / Issue 8 / June 2021
- Published online by Cambridge University Press:
- 18 March 2020, pp. 1329-1337
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background
Daily use of high-potency cannabis has been reported to carry a high risk for developing a psychotic disorder. However, the evidence is mixed on whether any pattern of cannabis use is associated with a particular symptomatology in first-episode psychosis (FEP) patients.
MethodWe analysed data from 901 FEP patients and 1235 controls recruited across six countries, as part of the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We used item response modelling to estimate two bifactor models, which included general and specific dimensions of psychotic symptoms in patients and psychotic experiences in controls. The associations between these dimensions and cannabis use were evaluated using linear mixed-effects models analyses.
ResultsIn patients, there was a linear relationship between the positive symptom dimension and the extent of lifetime exposure to cannabis, with daily users of high-potency cannabis having the highest score (B = 0.35; 95% CI 0.14–0.56). Moreover, negative symptoms were more common among patients who never used cannabis compared with those with any pattern of use (B = −0.22; 95% CI −0.37 to −0.07). In controls, psychotic experiences were associated with current use of cannabis but not with the extent of lifetime use. Neither patients nor controls presented differences in depressive dimension related to cannabis use.
ConclusionsOur findings provide the first large-scale evidence that FEP patients with a history of daily use of high-potency cannabis present with more positive and less negative symptoms, compared with those who never used cannabis or used low-potency types.
Transdiagnostic dimensions of psychopathology at first episode psychosis: findings from the multinational EU-GEI study
- Diego Quattrone, Marta Di Forti, Charlotte Gayer-Anderson, Laura Ferraro, Hannah E Jongsma, Giada Tripoli, Caterina La Cascia, Daniele La Barbera, Ilaria Tarricone, Domenico Berardi, Andrei Szöke, Celso Arango, Antonio Lasalvia, Andrea Tortelli, Pierre-Michel Llorca, Lieuwe de Haan, Eva Velthorst, Julio Bobes, Miguel Bernardo, Julio Sanjuán, Jose Luis Santos, Manuel Arrojo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean-Paul Selten, EU-GEI WP2 Group, Peter B Jones, James B Kirkbride, Alexander L Richards, Michael C O'Donovan, Pak C Sham, Evangelos Vassos, Bart PF Rutten, Jim van Os, Craig Morgan, Cathryn M Lewis, Robin M Murray, Ulrich Reininghaus
-
- Journal:
- Psychological Medicine / Volume 49 / Issue 8 / June 2019
- Published online by Cambridge University Press:
- 04 October 2018, pp. 1378-1391
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Background
The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.
MethodThis study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.
ResultsA bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.
ConclusionsOur results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.