| 1. |
- Abé, Christoph, et al.
(författare)
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Cortical brain structure and sexual orientation in adult females with bipolar disorder or attention deficit hyperactivity disorder
- 2018
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279 .- 2162-3279. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nonheterosexual individuals have higher risk of psychiatric morbidity. Together with growing evidence for sexual orientation‐related brain differences, this raises the concern that sexual orientation may be an important factor to control for in neuroimaging studies of neuropsychiatric disorders.Methods: We studied sexual orientation in adult psychiatric patients with bipolar disorder (BD) or ADHD in a large clinical cohort (N = 154). We compared cortical brain structure in exclusively heterosexual women (HEW, n = 29) with that of nonexclusively heterosexual women (nHEW, n = 37) using surface‐based reconstruction techniques provided by FreeSurfer.Results: The prevalence of nonheterosexual sexual orientation was tentatively higher than reported in general population samples. Consistent with previously reported cross‐sex shifted brain patterns among homosexual individuals, nHEW patients showed significantly larger cortical volumes than HEW in medial occipital brain regions.Conclusion: We found evidence for a sex‐reversed difference in cortical volume among nonheterosexual female patients, which provides insights into the neurobiology of sexual orientation, and may provide the first clues toward a better neurobiological understanding of the association between sexual orientation and mental health. We also suggest that sexual orientation is an important factor to consider in future neuroimaging studies of populations with certain mental health disorders.
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| 2. |
- Pålsson, Erik, 1975, et al.
(författare)
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Cerebrospinal fluid monoamine metabolite profiles in bipolar disorder, ADHD, and controls.
- 2017
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Ingår i: Journal of neural transmission (Vienna, Austria : 1996). - : Springer Science and Business Media LLC. - 1435-1463 .- 0300-9564. ; 124:9
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Tidskriftsartikel (refereegranskat)abstract
- Alterations in monoaminergic signaling are suggested as key aspects of the pathophysiology in bipolar disorder and ADHD, but it is not known if the monoamine metabolic profile differs between these disorders. One method to study monoaminergic systems in humans is to measure monoamine end-point metabolite concentrations in cerebrospinal fluid (CSF). Here, we analyzed CSF monoamine metabolite concentrations in 103 adults with bipolar disorder, 72 adults with ADHD, and 113 controls. Individuals with bipolar disorder had significantly higher homovanillic acid (HVA, 264±112nmol/L, p<0.001) and 5-hydroxyindoleacetic acid (5-HIAA, 116±42nmol/L, p=0.001) concentration, but lower 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG, 38±8nmol/L, p<0.001) concentrations than controls (HVA, 206±70nmol/L; 5-HIAA, 98±31nmol/L; and MHPG, 42±7nmol/L). Higher HVA concentrations were associated with a history of psychosis in the bipolar disorder sample. Subjects with ADHD had higher HVA (240±94nmol/L, p<0.001) concentrations compared with controls. In addition, SSRI treatment was associated with lower 5-HIAA concentrations in both patient groups. A power analysis indicated that for within-group comparisons, only large effects would be reliably detectable. Thus, there may be moderate-to-small effects caused by medication that were not detected due to the limited size of the sub-groups in these analyses. In conclusion, the present study suggests disorder-specific alterations of CSF monoamine metabolite concentrations in patients with bipolar disorder and ADHD compared with controls; these differences were independent of acute symptoms and medication effects.
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| 3. |
- Salarvan, Sara, et al.
(författare)
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Neuropsychological profiles of adult bipolar disorder patients with and without comorbid attention-deficit hyperactivity disorder.
- 2019
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Ingår i: International journal of bipolar disorders. - : Springer Science and Business Media LLC. - 2194-7511. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Comorbid attention-deficit/hyperactivity disorder (ADHD) is common in bipolar disorder and associated with worse outcomes. Cognitive testing might be a tool to identify this group. Here we compare the neuropsychological profiles of bipolar disorder patients with (BD+cADHD) and without (BD-cADHD) childhood attention-deficit hyperactivity disorder.Adult patients with BD-cADHD (n=66), BD+cADHD (n=32), and healthy controls (n=112) were tested using a comprehensive battery of neuropsychological tests. Patients underwent rigorous diagnostic assessments for bipolar disorder and ADHD, as well as a parental interview to establish childhood ADHD.The neuropsychological profiles of the groups were similar, except that the BD+cADHD group performed significantly worse on working memory. Working memory did not differ between those in the BD+cADHD group who only had a history of childhood ADHD and those that still met criteria for ADHD in adulthood.Cognitive testing had limited power to differentiate between bipolar disorder adults with and without childhood ADHD. The BD+cADHD subgroup cannot explain the significant cognitive heterogeneity seen in bipolar disorder patients.
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| 4. |
- Viktorin, Alexander, et al.
(författare)
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The Risk of Treatment-Emergent Mania With Methylphenidate in Bipolar Disorder
- 2017
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Ingår i: American Journal of Psychiatry. - Arlington, USA : American Psychiatric Association Publishing. - 0002-953X .- 1535-7228. ; 174:4, s. 341-348
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The authors sought to determine the risk of treatment-emergent mania associated with methylphenidate, used in monotherapy or with a concomitant mood-stabilizing medication, in patients with bipolar disorder.Method: Using linked Swedish national registries, the authors identified 2,307 adults with bipolar disorder who initiated therapy with methylphenidate between 2006 and 2014. The cohort was divided into two groups: those with and those without concomitant mood-stabilizing treatment. To adjust for individual-specific confounders, including disorder severity, genetic makeup, and early environmental factors, Cox regression analyses were used, conditioning on individual to compare the rate of mania (defined as hospitalization for mania or a new dispensation of stabilizing medication) 0-3 months and 3-6 months after medication start following nontreated periods.Results: Patients on methylphenidate monotherapy displayed an increased rate of manic episodes within 3 months of medication initiation (hazard ratio=6.7, 95% CI=2.0-22.4), with similar results for the subsequent 3 months. By contrast, for patients taking mood stabilizers, the risk of mania was lower after starting methylphenidate (hazard ratio=0.6, 95% CI=0.4-0.9). Comparable results were observed when only hospitalizations for mania were counted.Conclusions: No evidence was found for a positive association between methylphenidate and treatment-emergent mania among patients with bipolar disorder who were concomitantly receiving a mood-stabilizing medication. This is clinically important given that up to 20% of people with bipolar disorder suffer from comorbid ADHD. Given the markedly increased hazard ratio of mania following methylphenidate initiation in bipolar patients not taking mood stabilizers, careful assessment to rule out bipolar disorder is indicated before initiating monotherapy with psychostimulants.
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