Evidence for accelerated vascular aging in bipolar disorder

Sodhi, Simrit K.; Linder, Jonathan R.; Chenard, Catherine A.; Miller, Del D.; Haynes, William G.; Fiedorowicz, Jess G.

doi:10.1016/j.jpsychores.2012.06.004

Cited by 50 publications

(31 citation statements)

References 38 publications

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“…Such physiological effects could explain the dose-response between depressive symptom burden and vascular outcomes [22, 23]. The neurobiological underpinnings of depression may most plausibly mediate any such vascular effects through alterations in the hypothalamic-pituitary-adrenal axis, the autonomic nervous system, and inflammation.…”

Section: Discussionmentioning

confidence: 99%

The development of depressive symptoms during medical internship stress predicts worsening vascular function

Fiedorowicz¹,

Ellingrod²,

Kaplan³

et al. 2015

Journal of Psychosomatic Research

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Objective We sought to prospectively determine whether the onset of internship stress and any subsequent depression alters physiological markers of early vascular disease Methods We explored potential mechanisms linking stress and depression to vascular disease in a prospective cohort of 37 participants exposed to medical internship stress, an established precipitant of depressive symptomatology. Results Change in depressive symptom score from baseline over one year of internship stress was inversely correlated with change in the reactive hyperemia index (RHI), a measure of peripheral endothelial function (r=0.41, p=0.01). The change in depressive symptoms in the first six months of internship was similarly related to change in RHI over one year (r=0.38, p=0.02). While the development of depressive symptoms did not significantly impact changes in endothelial progenitor cells (EPCs), EPCs did significantly decrease with the year of internship stress (11.9 to 3.4 cells/ml blood; p=0.01). Conclusion Endothelial function may be a critical link between stress, depression, and cardiovascular disease and a feasible surrogate outcome for prospective studies.

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Section: Discussionmentioning

confidence: 99%

The development of depressive symptoms during medical internship stress predicts worsening vascular function

Fiedorowicz¹,

Ellingrod²,

Kaplan³

et al. 2015

Journal of Psychosomatic Research

Self Cite

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“…Chart diagnosis was confirmed in clinical interview. We retrospectively assessed the burden of mood symptoms using previously reported methods (Sodhi et al , 2012). No participants were included if they had history of cancer, untreated thyroid disease, pregnancy, or peripheral vascular disease.…”

Section: Methodsmentioning

confidence: 99%

Effects of antipsychotic drugs on cardiovascular variability in participants with bipolar disorder

Linder

Sodhi

Haynes

et al. 2014

Hum. Psychopharmacol Clin Exp

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Objective The risk for cardiovascular diseases is elevated in persons with bipolar disorder. However, it remains unknown how much of this excess risk is secondary to pharmacologic treatment. We tested the hypothesis that current and cumulative antipsychotic drug exposure is associated with increased cardiovascular risk as indicated by lower heart rate variability (HRV) and increased blood pressure variability (BPV). Methods 55 individuals with bipolar disorder (33±7 years; 67% female) underwent non-invasive electrocardiogram assessment of time- and frequency-domain HRV, as well as BPV analysis. Medication histories were obtained through systematic review of pharmacy records for the past five years. Results Current antipsychotic exposure was associated with lower SDNN. Second generation antipsychotics were associated with lower SDNN and RMSSD. There was no significant relationship between five-year antipsychotic exposure and HRV in subjects with bipolar disorder. Exploratory analysis revealed a possible link between SSRI exposure and increased low frequency spectral HRV. Conclusions Current antipsychotic use (particularly second generation antipsychotics with high affinities for the D2S receptor) is associated with reduced autonomic-mediated variability of heart rate. The absence of an association with cumulative exposure suggests that the effects are acute in onset, and may therefore relate more to altered autonomic function than structural cardiovascular abnormalities. Future studies should prospectively examine effects of these antipsychotics on autonomic function.

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“…Bipolar disorder (BD) may also be characterized by “accelerated aging” (Rizzo et al, 2014; Sodhi et al, 2012; Yatham et al, 2009 (but see Gildengers et al, 2013)). Six studies have examined LTL in BD subjects (type I, type II or rapid cycling) (Table 2).…”

Section: Telomere Length In Psychiatric Illnessesmentioning

confidence: 99%

Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging

Lindqvist

Epel

Mellon³

et al. 2015

Neuroscience & Biobehavioral Reviews

271

231

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Many psychiatric illnesses are associated with early mortality and with an increased risk of developing physical diseases that are more typically seen in the elderly. Moreover, certain psychiatric illnesses may be associated with accelerated cellular aging, evidenced by shortened leukocyte telomere length (LTL), which could underlie this association. Shortened LTL reflects a cell's mitotic history and cumulative exposure to inflammation and oxidation as well as the availability of telomerase, a telomere-lengthening enzyme. Critically short telomeres can cause cells to undergo senescence, apoptosis or genomic instability, and shorter LTL correlates with poorer health and predicts mortality. Emerging data suggest that LTL may be reduced in certain psychiatric illnesses, perhaps in proportion to exposure to the psychiatric illnesses, although conflicting data exist. Telomerase has been less well characterized in psychiatric illnesses, but a role in depression and in antidepressant and neurotrophic effects has been suggested by preclinical and clinical studies. In this article, studies on LTL and telomerase activity in psychiatric illnesses are critically reviewed, potential mediators are discussed, and future directions are suggested. A deeper understanding of cellular aging in psychiatric illnesses could lead to re-conceptualizing Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. DISCLOSURESJL is a consultant to Telomere Diagnostics Inc., formerly Telome Health, and owns stock in the company. The company had no role in this research or in writing this review. The remaining authors report no current disclosures or conflicts of interest. HHS Public Access

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Evidence for accelerated vascular aging in bipolar disorder

Cited by 50 publications

References 38 publications

The development of depressive symptoms during medical internship stress predicts worsening vascular function

The development of depressive symptoms during medical internship stress predicts worsening vascular function

Effects of antipsychotic drugs on cardiovascular variability in participants with bipolar disorder

Psychiatric disorders and leukocyte telomere length: Underlying mechanisms linking mental illness with cellular aging

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