Duration of untreated bipolar disorder: a multicenter study

Zhang, Ling; Yu, Xinguang; Fang, Yi; Ungvári, Gábor S.; Ng, Chee H.; Chiu, Helen F. K.; Li, Hui Chun; Yang, Hai Chen; Tan, Qing Rong; Xu, Xiu Feng; Wang, Gang; Xiang, Yu‐Tao

doi:10.1038/srep44811

Cited by 24 publications

(25 citation statements)

References 28 publications

(48 reference statements)

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“…In this perspective, in the present study, we also included the assessment of DUI, a clinical variable that has been associated with deleterious characteristics in the prognosis of BD (Altamura et al, 2015(Altamura et al, , 2010Hong et al, 2016;Zhang et al, 2017) and other psychiatric disorders (Altamura, Dell'Osso, D'Urso, et al, 2008;Altamura et al, 2007;Altamura, Dell'Osso, Vismara & Mundo, 2008). The mean DUI in our sample was 77.2 ± 103.0 months and was significantly longer for BD-II, compared to BD-I, BD-NOS and cyclothymia patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and patterns of psychopharmacological prescription in bipolar patients with vs without anxiety disorders at onset

Galimberti

Caricasole

Bosi

et al. 2019

Early Intervention Psych

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Aim: Up to just over half of bipolar disorder (BD) patients report at least one-lifetime anxiety disorder (AD). In some, anxiety represents the earliest psychiatric manifestation, prior to any mood episode. We sought to investigate prevalence of AD subtypes as first psychiatric manifestations and AD's relations with duration of untreated illness (DUI) and treatment among BD outpatients. Methods: We recruited patients referred to the Centre for the Treatment of Depressive Disorders in Milan, diagnosed with BD-I, BD-II, BD not otherwise specified (BD-NOS) and cyclothymia according to Diagnostic and Statistical Manual fourth edition-text revision criteria. Several clinical characteristics were assessed through retrospective chart review and/or direct patient interviews. Based on presence/ absence of an AD at psychiatric onset, eligible subjects were stratified into two groups (A+ and A−) and clinical features were compared between these groups and between BD subtypes. Results: We analysed 260 BD patients (77 BD-I, 122 BD-II, 45 BD-NOS and 16 cyclothymia). An AD was the first psychiatric manifestation in 69 patients (26.5%). BD-II and BD-NOS more frequently had an AD at psychiatric onset, with panic disorder being the most common AD. Among A+ vs A−, age at BD onset was younger, duration of untreated BD illness (DUI) was longer, and a mood stabilizer/antipsychotic was less often prescribed at psychiatric onset.

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Section: Discussionmentioning

confidence: 99%

Clinical features and patterns of psychopharmacological prescription in bipolar patients with vs without anxiety disorders at onset

Galimberti

Caricasole

Bosi

et al. 2019

Early Intervention Psych

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“…Major depressive disorder (MDD) is a serious mental disorder with high rates of morbidity, recurrence, and disability ( 1 – 3 ) that is associated with genetic factors, psychological factors and atypical brain structure or function ( 4 , 5 ). Despite differences in pathogenesis, genetics, pathophysiology, etc., bipolar depression (BD) can easily be misdiagnosed as a subtype of MDD ( 6 ) due to its parallel clinical characteristic ( 7 ). It is important that these disorders are differentially diagnosed to ensure that relevant treatments are initiated, and to assist in this innovative approaches are critical.…”

Section: Introductionmentioning

confidence: 99%

The Metabolic Factor Kynurenic Acid of Kynurenine Pathway Predicts Major Depressive Disorder

et al. 2018

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Background: Metabolic factors in the kynurenine pathway (KP) have been widely accepted as being a major mechanism in Major Depressive Disorder (MDD). However, the effects of these metabolites on the degree and pattern of MDD are still poorly understood, partly due to the elusiveness of the level of metabolites when diagnosing depression. This study aimed to explore a novel diagnostic method analyzing peripheral blood with mass spectrometry to assess metabolites from KP in patients with MDD and Bipolar Depression (BD).Methods: Thirty-three patients with MDD, 20 patients with BD, and 23 healthy control participants were enrolled Metabolic factors of KP from plasma including tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), and quinolinic acid (QUIN) were analyzed by UPLC-3Q-MS, and levels compared across three groups. Correlation between HAMD scores and metabolite levels conducted. Receiver operating characteristic (ROC) curve was used to determine the diagnostic value of metabolic factors in MDD.Results: Levels of KYNA, QUIN, KYNA/QUIN, and KYNA/KYN were statistically different across the three groups (P < 0.05); HAMD scores and TRP, KYN, KYNA/QUIN levels were negatively correlated in the MDD group (r = −0.633, −0.477, −0.418, P < 0.05); Accuracy of KYNA diagnosing MDD was 82.5% with the optimal diagnostic value being 15.48 ng/ml. Diagnostic accuracy was increased to 83.6% when KYNA and QUIN levels were used in combination.Conclusion: This results indicate that metabolic factors of KP play a crucial role in the occurrence and development of MDD, supporting the metabolic imbalance hypothesis of MDD. Furthermore, our study also provides a new diagnostic method to study MDD based on plasma KYNA level, and suggests that KYNA would be a potential biomarker in diagnosing depression patients.

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“…Researchers have underscored the difficulty in the initial identification and, the resulting delay in the accurate diagnosis of mood disorders, which is of the magnitude of several years in many patients. This results in inadequate or inappropriate treatment, and a consequent exacerbation of the diathesis [ 3 ]. Therefore, patients suffer repeated mood flare-ups, inter-episode sub-threshold symptoms, and the development of such complications as substance abuse.…”

Section: Introductionmentioning

confidence: 99%

The Staging of Major Mood Disorders: Clinical and Neurobiological Correlates

Muneer

Mazommil²

2018

Psychiatry Investig

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ObjectiveStaging of psychiatric disorders is gaining momentum and the purpose of this review is to examine whether major mood disorders can be defined according to stages. MethodsIn April 2018 the PubMed electronic data base was scrutinized by a combination of various search terms like “major depressive disorder and staging,” “bipolar disorder and neuroprogression,” etc. To incorporate the latest findings the search was limited to the last 10 years. Both original and review articles were examined by reading the abstracts, and papers which were found to be particularly applicable were read in full and their reference lists were also consulted. ResultsA significant increase occurred in the number of papers published on the topic of staging of mood disorders. Staging formats were found for both major mood disorders, with the caveat that many more articles were discovered for bipolar disorder. Current evidence points to allostatic load and neuroprogression as the basis for staging of mood disorders. ConclusionPrincipal affective illnesses may be characterized by distinct stages, for instance early, intermediate and late. These phases inform the management so that clinicians should incorporate the staging schema into everyday practice and implement treatment strategies according to the phase of the illness.

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Duration of untreated bipolar disorder: a multicenter study

Cited by 24 publications

References 28 publications

Clinical features and patterns of psychopharmacological prescription in bipolar patients with vs without anxiety disorders at onset

Clinical features and patterns of psychopharmacological prescription in bipolar patients with vs without anxiety disorders at onset

The Metabolic Factor Kynurenic Acid of Kynurenine Pathway Predicts Major Depressive Disorder

The Staging of Major Mood Disorders: Clinical and Neurobiological Correlates

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