Five‐year outcome of bipolar I and II disorders: findings of the Jorvi Bipolar Study

Pallaskorpi, Sanna; Suominen, Kirsi; Ketokivi, Mikko; Mantere, Outi; Arvilommi, Petri; Valtonen, Hannu; Leppämäki, Sami; Isometsä, Erkki

doi:10.1111/bdi.12291

Cited by 44 publications

(56 citation statements)

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“…Depressive episodes can be severe with often long‐term subsyndromal residual symptoms. Manic episodes are acutely very intense, but full remission is reached much sooner . Our results indicate that in both situations of altered mood, ie chronic subsyndromal depressive symptoms and acute mania, the kynurenine pathway is susceptible to inflammation and may produce a neurotoxic metabolic response.…”

Section: Discussionmentioning

confidence: 73%

A mood state‐specific interaction between kynurenine metabolism and inflammation is present in bipolar disorder

et al. 2019

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Objectives Cytokines are thought to contribute to the pathogenesis of psychiatric symptoms by kynurenine pathway activation. Kynurenine metabolites affect neurotransmission and can cause neurotoxicity. We measured inflammatory markers in patients with bipolar disorder (BD) and studied their relation to kynurenine metabolites and mood. Methods Patients with BD suffering from an acute mood episode were assigned to the depressive (n = 35) or (hypo)manic (n = 32) subgroup. Plasma levels of inflammatory markers [cytokines, C‐reactive protein] and kynurenine metabolites [tryptophan (TRP), kynurenine (KYN), 3‐hydroxykynurenine (3‐HK), quinolinic acid (QA), kynurenic acid (KYNA)] were measured on 6 time points during 8 months follow‐up. Biological marker levels in patients were compared to controls (n = 35) and correlated to scores on mood scales. Spearman correlations and linear mixed models were used for statistical analysis. Results Twenty patients of the manic subgroup, 29 of the depressive subgroup, and 30 controls completed the study. The manic subgroup had a rapid remission of mood symptoms, but in the depressive subgroup subsyndromal symptoms persisted. No differences in inflammation were found between groups. A strong correlation between tumor necrosis factor‐α and KYN, KYN/TRP, 3‐HK and QA (ρ > 0.60) was specific for the manic group, but only at baseline (during mania). The depressive subgroup had a lower neuroprotective ratio (KYNA/3‐HK, P = .0004) and a strong association between interferon‐y and kynurenine pathway activation (P < .0001). KYNA was low in both patient groups versus controls throughout the whole follow‐up (P = .0008). Conclusions Mania and chronic depressive symptoms in BD are accompanied by a strong interaction between inflammation and a potentially neurotoxic kynurenine metabolism.

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Section: Discussionmentioning

confidence: 73%

A mood state‐specific interaction between kynurenine metabolism and inflammation is present in bipolar disorder

et al. 2019

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“…The methodology of JoBS has been described in detail elsewhere . In brief, the Mood Disorder Questionnaire (MDQ) was used to screen for all possible new DSM‐IV BD episodes in inpatients and outpatients in the catchment area of Jorvi Hospital during the study period (January 2002 to February 2003).…”

Section: Methodsmentioning

confidence: 99%

“…Details of the follow‐up methodology have been described previously . Using a life‐chart method similar but not identical to the Longitudinal Interval Follow‐up Evaluation methodology developed by Keller et al., we identified the duration and timing of major depressive, hypomanic, manic, mixed, depressive mixed, cyclothymic and substance‐induced phases of BD as well as the subsyndromal states of hypomanic and depressive symptoms by interviewing the patients at 6 and 18 months and at 5 years . Definitions of DSM‐IV for the phases of BD were used with two exceptions: (i) the depressive mixed state was defined according to the DMX3 definition (i.e.…”

Section: Methodsmentioning

confidence: 99%

Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5‐year follow‐up study

Pallaskorpi

Suominen²,

Ketokivi

et al. 2017

Bipolar Disorders

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Funding information theFinnishMedicalFoundationObjectives: Fewlong-termstudiesonbipolardisorder(BD)haveinvestigatedtheincidenceandriskfactorsofsuicideattempts(SAs)specificallyrelatedtoillnessphases.WeexaminedtheincidenceofSAsduringdifferentphasesofBDinalong-termprospectivecohortofbipolarI(BD-I)andbipolarII(BD-II)patients,andriskfactorsspecificallyforSAsduringmajordepressiveepisodes(MDEs). MDEs, severity of depression, and cluster C personality disorders were significant predictors. Methods

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“…Pacijenti provode oko 1/3 vremena u epizodama poremećaja, a 15% vremena u subsindromalnim simptomima. Samo polovinu vremena su eutimični [5].…”

Section: Uvodunclassified

Cognitive-behavioral therapy in the treatment of bipolar affective disorder

Batinić¹,

Duišin²,

Milovanović³

2015

Engrami

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Kratak sadržajUprkos napretku u farmakološkom tretmanu bipolarnog afektivnog poremećaja, značajan broj pacijenata doživljava ponavljane epizode, subsindromalne simptome i kontinuirana psihosocijalna oštećenja između epizoda, kao i slabo prihvatanje farmakoterapije. Pacijenti sa bipolarnim afektivnim poremećajem se suočavaju sa hroničnim tokom poremećaja, specifičnim problemima vezanim za depresivne i manične epizode, stigmatizacijom, životnim događajima i stresorima koji provociraju nove epizode, doživotnim korišćenjem lekova, narušava-njem socio-profesionalnih kompetencija, kao i pitanjima herediteta.Pregled literature ukazuje da primena kognitivno-bihejvioralne terapije (KBT) kao dodatak na farmakoterapijski tretman redukuje težinu simptoma, povećava efekat stabilizatora raspoloženja u redukciji stopa relapsa, modifikuje disfunkcionalne kognicije i ponašanja koja mogu pogoršati tok poremećaja, poboljšava prihvatanje farmakoterapijskog režima, razvija kognitivnobihejvioralne veštine od pomoći pacijentu u prevladavanju prodroma novih epizoda, redukciji stresa i vulnerabilnosti, poboljšava interpersonalno funkcionisanje i porodične komunikacije. Pored individualne, i dodavanja grupne KBT stabilizatorima raspoloženja se pokazalo efikasnim u redukciji simptoma manije, depresije i anksioznosti, kao i manjem broju i kraćem trajanju izmena raspoloženja.U radu su predstavljeni kognitivni model bipolarnog afektivnog poremećaja, kao i osnovni principi kognitivno-bihejvioralnog tretmana koji uključuju optimizaciju terapijskog saveza, normalizaciju i destigmatizaciju iskustva mentalnog poremećaja, psihoedukaciju, strategije za ranu detekciju poremećaja, kognitivnu restrukturaciju i bihejvioralne veštine, poboljšanje prihvatanja farmakoterapije, tretman komorbidnih poremećaja, razvoj individualnih veština za prevenciju relapsa kao i porodične intervencije.Ključne reči: kognitivno-bihejvioralna terapija, bipolarni afektivni poremećaj

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Five‐year outcome of bipolar I and II disorders: findings of the Jorvi Bipolar Study

Cited by 44 publications

References 64 publications

A mood state‐specific interaction between kynurenine metabolism and inflammation is present in bipolar disorder

A mood state‐specific interaction between kynurenine metabolism and inflammation is present in bipolar disorder

Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5‐year follow‐up study

Cognitive-behavioral therapy in the treatment of bipolar affective disorder

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