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Frontiers in Psychiatry 2024White matter hyperintensities are lesions of presumed vascular origin associated with Cerebral small vessel disease. WMH are common findings that and are associated with...
BACKGROUND
White matter hyperintensities are lesions of presumed vascular origin associated with Cerebral small vessel disease. WMH are common findings that and are associated with increased risk of cognitive impairment and dementia. A higher prevalence of WMH has been also reported in patients with bipolar disorder (BD), although the evidence is conflicting.
OBJECTIVE
To compare the prevalence of WMH in adults with BD, with the prevalence found in healthy controls.
METHODS
We searched the Embase, Medline/PubMed, and references cited in articles retrieved on May 20, 2023. We included case-control studies that compared the prevalence of WMH in adult BD patients with the prevalence of WMH in healthy controls, using T2-weighted magnetic resonance imaging. We performed a meta-analysis using a random-effects method based on the inverse-variance approach.
FINDINGS
We included 22 case-control studies reporting data of 1313 people. The overall rate of WMH was 46.5% in BD patients and 28% in controls (pooled Odds Ratio 2.89, 95% CI 1.76; 4.75). We found a moderate heterogeneity across studies (I 0.49). Publication bias was not significant.
INTERPRETATION
We found evidence that BD patients have a higher burden of WMH than healthy controls. Main limitations were impossibility of analyzing gender differences and bipolar type, moderate heterogeneity between studies, non-representative samples, lack of control for major confounders and search in two electronic databases.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428464.
PubMed: 38343622
DOI: 10.3389/fpsyt.2024.1343463 -
Drug and Alcohol Dependence Reports Mar 2024Given the risks to mental health associated with cannabis use in youth and the increase in cannabis legalization worldwide and in the U.S., there is a need to understand... (Review)
Review
Given the risks to mental health associated with cannabis use in youth and the increase in cannabis legalization worldwide and in the U.S., there is a need to understand existing evidence-based approaches to integrated management of psychiatric disorders in youth who use cannabis. This systematic review aimed to appraise the current evidence on integrated treatment for adolescents and young adults with common psychiatric disorders who engage in regular cannabis use. A total of 989 studies were screened for inclusion. Study's titles and abstracts were screened and advanced to full text review for further screening by two independent reviewers. Thirty-five full-text articles were reviewed, with five articles ultimately meeting all criteria for inclusion. Five randomized controlled trials examined the effects of therapeutic interventions in youth with common psychiatric disorders who used cannabis, including two studies on depression, one on bipolar disorder, one on anxiety and one on PTSD were reviewed. No studies were considered high in risk of bias. Overall, there is a paucity of research on the treatment of comorbid adolescent mental health disorders and cannabis use, which limits the ability to draw evidence-based treatment recommendations.
PubMed: 38288007
DOI: 10.1016/j.dadr.2023.100216 -
Neuroscience and Biobehavioral Reviews Mar 2024The use of probiotics, prebiotics, synbiotics or fermented foods can modulate the gut-brain axis and constitute a potentially therapeutic intervention in psychiatric... (Review)
Review
The use of probiotics, prebiotics, synbiotics or fermented foods can modulate the gut-brain axis and constitute a potentially therapeutic intervention in psychiatric disorders. This systematic review aims to identify current evidence regarding these interventions in the treatment of patients with DSM/ICD psychiatric diagnoses. Forty-seven articles from 42 studies met the inclusion criteria. Risk of bias was assessed in all included studies. Major depression was the most studied disorder (n = 19 studies). Studies frequently focused on schizophrenia (n = 11) and bipolar disorder (n = 5) and there were limited studies in anorexia nervosa (n = 4), ADHD (n = 3), Tourette (n = 1), insomnia (n = 1), PTSD (n = 1) and generalized anxiety disorder (n = 1). Except in MDD, current evidence does not clarify the role of probiotics and prebiotics in the treatment of mental illness. Several studies point to an improvement in the immune and inflammatory profile (e.g. CRP, IL6), which may be a relevant mechanism of action of the therapeutic response identified in these studies. Future research should consider lifestyle and dietary habits of patients as possible confounders that may influence inter-individual treatment response.
Topics: Humans; Prebiotics; Synbiotics; Probiotics; Mental Disorders
PubMed: 38280441
DOI: 10.1016/j.neubiorev.2024.105561 -
Psychotherapy and Psychosomatics 2024Cognitive dysfunction or deficits are common in patients with major depressive disorder (MDD). The current study systematically reviews and meta-analyzes multiple... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Cognitive dysfunction or deficits are common in patients with major depressive disorder (MDD). The current study systematically reviews and meta-analyzes multiple domains of cognitive impairment in patients with MDD.
METHODS
PubMed/MEDLINE, PsycINFO, Cochrane Library, Embase, Web of Science, and Google Scholar were searched from inception through May 17, 2023, with no language limits. Studies with the following inclusion criteria were included: (1) patients with a diagnosis of MDD using standardized diagnostic criteria; (2) healthy controls (i.e., those without MDD); (3) neuropsychological assessments of cognitive impairment using Cambridge Neuropsychological Test Automated Battery (CANTAB); and (4) reports of sufficient data to quantify standardized effect sizes. Hedges' g standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were used to quantify effect sizes of cognitive impairments in MDD. SMDs were estimated using a fixed- or random-effects models.
RESULTS
Overall, 33 studies consisting of 2,596 subjects (n = 1,337 for patients with MDD and n = 1,259 for healthy controls) were included. Patients with MDD, when compared to healthy controls, had moderate cognitive deficits (SMD, -0.39 [95% CI, -0.47 to -0.31]). In our subgroup analyses, patients with treatment-resistant depression (SMD, -0.56 [95% CI, -0.78 to -0.34]) and older adults with MDD (SMD, -0.51 [95% CI, -0.66 to -0.36]) had greater cognitive deficits than healthy controls. The effect size was small among unmedicated patients with MDD (SMD, -0.19 [95% CI, -0.37 to -0.00]), and we did not find any statistical difference among children. Cognitive deficits were consistently found in all domains, except the reaction time. No publication bias was reported.
CONCLUSION
Because cognitive impairment in MDD can persist in remission or increase the risk of major neurodegenerative disorders, remediation of cognitive impairment in addition to alleviation of depressive symptoms should be an important goal when treating patients with MDD.
Topics: Child; Humans; Aged; Depressive Disorder, Major; Cognitive Dysfunction; Neuropsychological Tests
PubMed: 38272009
DOI: 10.1159/000535665 -
International Clinical... Jul 2024Cerebellar alterations, including both volumetric changes in the cerebellar vermis and dysfunctions of the corticocerebellar connections, have been documented in...
INTRODUCTION
Cerebellar alterations, including both volumetric changes in the cerebellar vermis and dysfunctions of the corticocerebellar connections, have been documented in psychotic disorders. Starting from the clinical observation of a bipolar patient with cerebellar hypoplasia, the purpose of this review is to summarize the data in the literature about the association between hypoplasia of the cerebellar vermis and psychotic disorders [schizophrenia (SCZ) and bipolar disorder (BD)].
METHODS
A bibliographic search on PubMed has been conducted, and 18 articles were finally included in the review: five used patients with BD, 12 patients with SCZ and one subject at psychotic risk.
RESULTS
For SCZ patients and subjects at psychotic risk, the results of most of the reviewed studies seem to suggest a gray matter volume reduction coupled with an increase in white matter volumes in the cerebellar vermis, compared to healthy controls. Instead, the results of the studies on BD patients are more heterogeneous with evidence showing a reduction, no difference or even an increase in cerebellar vermis volume compared to healthy controls.
CONCLUSIONS
From the results of the reviewed studies, a possible correlation emerged between cerebellar vermis hypoplasia and psychotic disorders, especially SCZ, ultimately supporting the hypothesis of psychotic disorders as neurodevelopmental disorders.
Topics: Adult; Female; Humans; Bipolar Disorder; Cerebellar Vermis; Cerebellum; Developmental Disabilities; Magnetic Resonance Imaging; Nervous System Malformations; Psychotic Disorders; Schizophrenia
PubMed: 38266159
DOI: 10.1097/YIC.0000000000000535 -
Frontiers in Public Health 2023There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and...
BACKGROUND
There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however.
OBJECTIVE
The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons.
METHODS
Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency.
RESULTS
From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses.
CONCLUSION
This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.
Topics: Humans; Cannabis; Sedentary Behavior; Mental Health; Diet; Tobacco Use; Stress Disorders, Post-Traumatic
PubMed: 38249418
DOI: 10.3389/fpubh.2023.1268339 -
Indian Journal of Psychiatry Nov 2023After the National Mental Health Survey in 2016, multiple individual studies showed inconsistencies in the prevalence rates of psychiatric disorders in India. We... (Review)
Review
BACKGROUND
After the National Mental Health Survey in 2016, multiple individual studies showed inconsistencies in the prevalence rates of psychiatric disorders in India. We performed a meta-analysis to estimate an up-to-date pooled estimate of the prevalence of depression, alcohol use disorder (AUD), anxiety disorder (AD), intellectual disability, suicidal attempt/death, autism, and bipolar disorder (BD) in India.
MATERIALS AND METHODS
We performed a systematic bibliographic search in Pub Med, Global Health Data Exchange (GHDx), and Google Scholar, along with a manual search for peer-reviewed epidemiological studies reporting the prevalence of depression, AUD, AD, MR, suicidal attempt/death, autism, and BD in India from January 1980 till March 2022. Adopting a random-effects model, we performed the meta-analysis using "MetaXL" software.
RESULTS
A total of 79 studies were included: depression ( = 28), AUD ( = 14), AD ( = 12), intellectual disability ( = 8), suicidal attempt/death ( = 7), autism ( = 6) and BD ( = 4). The pooled prevalence of depression and AUD was 12.4% (95% CI 9.4-15.9) ( < 0.001, I = 100%) and 21.5% (95% CI 14.1-30.0) ( < 0.001, I = 100%), respectively. AD, intellectual disability and suicidal attempt/death showed a prevalence of 11.6% (95% CI 8.1-15.7) ( < 0.001, I = 99%), 1% (95% CI 0.5-1.6) ( < 0.001, I = 98%) and 0.5% (95% CI 0.3-0.8) ( < 0.001, I = 100%), respectively. The meta-analysis in autism and BD showed pooled prevalence of 0.3% (95% CI 0.1-0.6) ( < 0.001, I = 96%) and 0.3% (95% CI 0.2-0.4) ( < 0.001, I = 78%), respectively. Subgroup analysis showed an increased prevalence of AD in the urban [24.3% (95% CI 3.7-52.9)] and younger [16.7% (95% CI 5.1-32.7)] population. The prevalence of depression and AD increased during the last two decades on decadal prevalence analysis.
DISCUSSION
The findings could be used for appropriate policy measures and guiding subsequent national mental health surveys.
PubMed: 38249146
DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_539_22 -
Internet Interventions Mar 2024It is uncertain whether app-based interventions add value to existing mental health care. (Review)
Review
BACKGROUND
It is uncertain whether app-based interventions add value to existing mental health care.
OBJECTIVE
To examine the incremental effects of app-based interventions when used as adjunct to mental health interventions.
METHODS
We searched PubMed, PsycINFO, Scopus, Web of Science, and Cochrane Library databases on September 15th, 2023, for randomised controlled trials (RCTs) on mental health interventions with an adjunct app-based intervention compared to the same intervention-only arm for adults with mental disorders or respective clinically relevant symptomatology. We conducted meta-analyses on symptoms of different mental disorders at postintervention. PROSPERO, CRD42018098545.
RESULTS
We identified 46 RCTs (4869 participants). Thirty-two adjunctive app-based interventions passively or actively monitored symptoms and behaviour, and in 13 interventions, the monitored data were sent to a therapist. We found additive effects on symptoms of depression ( = 0.17; 95 % CI 0.02 to 0.33; = 7 comparisons), anxiety ( = 0.80; 95 % CI 0.06 to 1.54; = 3), mania ( = 0.2; 95 % CI 0.02 to 0.38; = 4), smoking cessation ( = 0.43; 95 % CI 0.29 to 0.58; = 10), and alcohol use ( = 0.23; 95 % CI 0.08 to 0.39; = 7). No significant effects were found on symptoms of depression within a bipolar disorder ( = -0.07; 95 % CI -0.37 to 0.23, = 4) and eating disorders ( = -0.02; 95 % CI -0.44 to 0.4, = 3). Studies on depression, mania, smoking, and alcohol use had a low heterogeneity between the trials. For other mental disorders, only single studies were identified. Only ten studies had a low risk of bias, and 25 studies reported insufficient statistical power.
DISCUSSION
App-based interventions may be used to enhance mental health interventions to further reduce symptoms of depression, anxiety, mania, smoking, and alcohol use. However, the effects were small, except for anxiety, and limited due to study quality. Further high-quality research with larger sample sizes is warranted to better understand how app-based interventions can be most effectively combined with established interventions to improve outcomes.
PubMed: 38225971
DOI: 10.1016/j.invent.2023.100703 -
The International Journal of... Feb 2024Cannabis use is a risk factor of psychiatric illness, such as bipolar disorder type-I (BDI). Indeed, cannabis use strongly influences the onset and clinical course of...
BACKGROUND
Cannabis use is a risk factor of psychiatric illness, such as bipolar disorder type-I (BDI). Indeed, cannabis use strongly influences the onset and clinical course of BDI, although the biological mechanisms underlying this interaction remain unknown. Therefore, we have reviewed the biological mechanisms affected by cannabis use that may trigger BD.
METHODS
A systematic review was carried out of articles in which gene expression was studied in cannabis users or human-derived cells exposed to tetrahydrocannabinol (THC) or cannabidiol (CBD). A second systematic review was then performed to identify articles in which gene expression was studied in BDI samples, highlighting those that described alterations to the same molecular and cellular mechanisms affected by cannabis/THC/CBD.
RESULTS
The initial search identified 82 studies on cannabis and 962 on BDI. After removing duplicates and applying the inclusion/exclusion criteria, 9 studies into cannabis and 228 on BDI were retained. The molecular and cellular mechanisms altered by cannabis use or THC/CBD exposure were then identified, including neural development and function, cytoskeletal function, cell adhesion, mitochondrial biology, inflammatory related pathways, lipid metabolism, the endocannabinoid system, the hypocretin/orexin system, and apoptosis. Alterations to those activities were also described in 19 of 228 focused on BDI.
CONCLUSIONS
The biological mechanisms described in this study may be good candidates to the search for diagnostic biomarkers and therapeutic targets for BDI. Because cannabis use can trigger the onset of BD, further studies would be of interest to determine whether they are involved in the early development of the disorder, prompting early treatment.
Topics: Humans; Cannabis; Bipolar Disorder; Cannabinoid Receptor Agonists; Cannabidiol; Hallucinogens; Risk Factors; Dronabinol
PubMed: 38175142
DOI: 10.1093/ijnp/pyae002 -
European Review For Medical and... Dec 2023Research shows that patients with bipolar disorders (BD) may have an altered risk of cardiovascular diseases; however, the association between the two is not clear. In... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Research shows that patients with bipolar disorders (BD) may have an altered risk of cardiovascular diseases; however, the association between the two is not clear. In this study, we reviewed evidence on the association between BD and subsequent risk of myocardial infarction (MI).
MATERIALS AND METHODS
Studies published on PubMed, Embase, Scopus, CENTRAL, and Web of Science were identified up to 30th August 2023. Random-effects meta-analysis was done to calculate the pooled odds ratio (OR).
RESULTS
A total of six studies with 19,862,894 individuals were included. Of these, 46,627 were diagnosed with BD (0.23%). The median follow-up of the studies varied from 7.6 to 20 years. Meta-analysis of all six studies showed that BD patients do not have a higher risk of MI as compared to the general population (OR: 1.36, 95% CI: 0.99, 1.86). The overall analysis had substantial heterogeneity with I2=86%. No publication bias was noted among the studies. Results did not change during sensitivity analysis.
CONCLUSIONS
Current evidence fails to show an association between BD and subsequent risk of MI. The high heterogeneity in the meta-analysis and lack of adjustment of all important confounders are significant limitations that need to be overcome by future studies.
Topics: Humans; Bipolar Disorder; Myocardial Infarction; Odds Ratio
PubMed: 38164842
DOI: 10.26355/eurrev_202312_34777