BACKGROUND: The clinical effects of smartphone-based interventions for bipolar disorder (BD) have yet to be established. OBJECTIVES: To examine the efficacy of smartphone-based interventions in BD and how the included studies reported user-engagement indicators. METHODS: We conducted a systematic search on January 24, 2022, in PubMed, Scopus, Embase, APA PsycINFO, and Web of Science. We used random-effects meta-analysis to calculate the standardized difference (Hedges' g) in pre-post change scores between smartphone intervention and control conditions. The study was pre-registered with PROSPERO (CRD42021226668). RESULTS: The literature search identified 6034 studies. Thirteen articles fulfilled the selection criteria. We included seven RCTs and performed meta-analyses comparing the pre-post change in depressive and (hypo)manic symptom severity, functioning, quality of life, and perceived stress between smartphone interventions and control conditions. There was significant heterogeneity among studies and no meta-analysis reached statistical significance. Results were also inconclusive regarding affective relapses and psychiatric readmissions. All studies reported positive user-engagement indicators. CONCLUSION: We did not find evidence to support that smartphone interventions may reduce the severity of depressive or manic symptoms in BD. The high heterogeneity of studies supports the need for expert consensus to establish ideally how studies should be designed and the use of more sensitive outcomes, such as affective relapses and psychiatric hospitalizations, as well as the quantification of mood instability. The ISBD Big Data Task Force provides preliminary recommendations to reduce the heterogeneity and achieve more valid evidence in the field.

• Klíčová slova
• bipolar disorder, efficacy, engagement, smartphone interventions, task force,
• MeSH
• big data MeSH
• bipolární porucha * psychologie   MeSH
• chytrý telefon * MeSH
• kvalita života MeSH
• lidé MeSH
• recidiva MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• systematický přehled MeSH

OBJECTIVE: More than 90% of people who attempt suicide have a psychiatric diagnosis; however, twin and family studies suggest that the genetic etiology of suicide attempt is partially distinct from that of the psychiatric disorders themselves. The authors present the largest genome-wide association study (GWAS) on suicide attempt, using cohorts of individuals with major depressive disorder, bipolar disorder, and schizophrenia from the Psychiatric Genomics Consortium. METHODS: The samples comprised 1,622 suicide attempters and 8,786 nonattempters with major depressive disorder; 3,264 attempters and 5,500 nonattempters with bipolar disorder; and 1,683 attempters and 2,946 nonattempters with schizophrenia. A GWAS on suicide attempt was performed by comparing attempters to nonattempters with each disorder, followed by a meta-analysis across disorders. Polygenic risk scoring was used to investigate the genetic relationship between suicide attempt and the psychiatric disorders. RESULTS: Three genome-wide significant loci for suicide attempt were found: one associated with suicide attempt in major depressive disorder, one associated with suicide attempt in bipolar disorder, and one in the meta-analysis of suicide attempt in mood disorders. These associations were not replicated in independent mood disorder cohorts from the UK Biobank and iPSYCH. No significant associations were found in the meta-analysis of all three disorders. Polygenic risk scores for major depression were significantly associated with suicide attempt in major depressive disorder (R2=0.25%), bipolar disorder (R2=0.24%), and schizophrenia (R2=0.40%). CONCLUSIONS: This study provides new information on genetic associations and demonstrates that genetic liability for major depression increases risk for suicide attempt across psychiatric disorders. Further collaborative efforts to increase sample size may help to robustly identify genetic associations and provide biological insights into the etiology of suicide attempt.

• Klíčová slova
• Genome-Wide Association Study, Mood Disorders, Polygenic Risk Scoring, Psychiatric Genomics Consortium, Schizophrenia, Suicide,
• MeSH
• bipolární porucha genetika   psychologie   MeSH
• celogenomová asociační studie MeSH
• depresivní porucha unipolární genetika   psychologie   MeSH
• lidé MeSH
• multifaktoriální dědičnost genetika   MeSH
• pokus o sebevraždu * MeSH
• rizikové faktory MeSH
• schizofrenie genetika   MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH

BACKGROUND: Mood regulation is a complex and poorly understood process. In this study, we aimed to analyze the underlying dynamics of mood regulation in unaffected first degree relatives of patients diagnosed with bipolar disorder using time-series analysis. METHODS: We recruited 30 unaffected first-degree relatives of bipolar disorder patients. Participants rated their mood, anxiety and energy levels using a paper-based visual analog scale; they recorded their sleep and life events as well. Participants provided information on these variables over a three month period, twice per day. We compared their data using Box-Jenkins time series analysis with data from 30 healthy controls (HC) and 30 euthymic bipolar patients (BD) to obtain information on the autocorrelation and cross-correlation of the series, and calculated entropy for mood, anxiety and energy series. RESULTS: We analyzed 14,980 data points: 5200 in the healthy control group; 4970 in the bipolar group and 4810 in the unaffected relatives group. There were no significant differences between groups in terms of age, sex or education levels. Using Kolmogorov-Smirnov test, we found that individual measures were normally distributed in the whole sample (D = 0.23, p > 0.1). Autocorrelation functions for mood in all groups are governed by the ARIMA (1,1,0) model, which means that current values in the series are related to one previous point only. In terms of entropy for the mood series, unaffected relatives and bipolar patients showed lower values [mean (SD) : 1.028 ± 0.679; 1.042 ± 0.680], respectively, compared to healthy controls [(1.476 ± 0.33); F (2,74) = 4.39, p < 0.01]. The same case was seen in the energy series, with lower values in the unaffected relatives and bipolar patient groups [mean (SD) : 1.644 ± 0.566; 1.511 ± 0.879], respectively, compared to healthy controls [2.230 ± 0.531; F(2, 75) = 7.89, p < 0.001]. LIMITATIONS: Low resolution for the visual analog scale. CONCLUSIONS: Using nonlinear analyses, we found that the underlying structure of mood regulation in unaffected relatives is undistinguishable from the one found in bipolar patients. Compared to healthy controls, both bipolar patients and their unaffected relatives showed lower entropy levels, which is in keeping with a more rigid system, not as flexible to cope with the demands of a changing environment.

• Klíčová slova
• Bipolar disorder, Mood regulation, Nonlinear, Time-series, Unaffected relatives,
• MeSH
• afekt * MeSH
• bipolární porucha diagnóza   psychologie   MeSH
• cyklotymní poruchy psychologie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nelineární dynamika MeSH
• sebekontrola psychologie   MeSH
• studie případů a kontrol MeSH
• úzkost psychologie   MeSH
• vizuální analogová stupnice MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• afekt * MeSH
• bipolární porucha psychologie   MeSH
• lidé MeSH
• modely neurologické MeSH
• teoretické modely MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodníky MeSH

BACKGROUND: Impairment of sleep and circadian rhythm is a typical feature of bipolar disorder (BD). We carried out an exploratory cross-sectional case-control study to extend the knowledge of sleep characteristics in offspring at risk for BD. METHODS: We investigated 42 offspring of bipolar parents (OB) (mean age 12.5 ± 3.2) and 42 sex and age matched comparison offspring of healthy parents. We administered the Pediatric Sleep Questionnaire, the Morningness/Eveningness Questionnaire and The General Behavior Inventory Sleep Subscale (GBISS) to assess circadian preference, and to identify sleep impairment symptoms. In addition, the participants completed 14 days of actigraphy to characterise sleep and wake patterns. The current psychopathology profile was assessed using Kiddie Schedule for Affective Disorders and Schizophrenia. RESULTS: Prevalence of sleep disturbance symptoms was higher among OB than controls (headache after waking up, 17.9% vs. 2.4%, p = 0.03; excessive daytime sleepiness, 38.5% vs. 10.0%, p = 0.004; apparent tiredness at wake-up times, 43.6% vs. 15.0%, p = 0.007 and nightmares, 21.6% vs. 2.4%, p = 0.01), but the differences between groups were not significant after adjusting for current psychopathology. OB had higher GBISS total score (parental version, p < 0.001; self-assessment, p = 0.07) than the controls. OB had higher preference for eveningness than the controls (p = 0.047). According to the actigraphy, OB had longer sleep onset latency (p = 0.048) than the controls. CONCLUSION: Evidence suggests that the offspring of bipolar parents experience sleep disturbance symptoms, which was associated with psychopathology in this study. Prospective longitudinal sleep studies would clarify whether sleep disturbance could be a predictor of mood disorder onset in this high-risk population.

• Klíčová slova
• Actigraphy, Adolescent, Bipolar disorder, Child, High-risk, Offspring, Sleep,
• MeSH
• aktigrafie MeSH
• bipolární porucha patofyziologie   psychologie   MeSH
• cirkadiánní rytmus MeSH
• dítě postižených rodičů psychologie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• poruchy spánku a bdění diagnóza   patofyziologie   MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• průzkumy a dotazníky MeSH
• rodiče psychologie   MeSH
• sebezhodnocení (psychologie) MeSH
• studie případů a kontrol MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Negative affective stimuli elicit behavioral and neural responses which vary on a continuum from adaptive to maladaptive, yet are typically investigated in a dichotomous manner (healthy controls vs. psychiatric diagnoses). This practice may limit our ability to fully capture variance from acute responses to negative affective stimuli to psychopathology at the extreme end. To address this, we conducted a functional magnetic resonance imaging study to examine the neural responses to negative valence/high arousal and neutral valence/low arousal images as a function of dysphoric mood and sex across individuals (n = 99) who represented traditional categories of healthy controls, major depressive disorder, bipolar psychosis, and schizophrenia. Observation of negative (vs. neutral) stimuli elicited blood oxygen-level dependent responses in the following circuitry: periaqueductal gray, hypothalamus (HYPO), amygdala (AMYG), hippocampus (HIPP), orbitofrontal cortex (OFC), medial prefrontal cortex (mPFC), and greater connectivity between AMYG and mPFC. Across all subjects, severity of dysphoric mood was associated with hyperactivity of HYPO, and, among females, right (R) AMYG. Females also demonstrated inverse relationships between severity of dysphoric mood and connectivity between HYPO - R OFC, R AMYG - R OFC, and R AMYG - R HIPP. Overall, our findings demonstrated sex-dependent deficits in response to negative affective stimuli increasing as a function of dysphoric mood state. Females demonstrated greater inability to regulate arousal as mood became more dysphoric. These findings contribute to elucidating biosignatures associated with response to negative stimuli across disorders and suggest the importance of a sex-dependent lens in determining these biosignatures. Hum Brain Mapp 37:3733-3744, 2016. © 2016 Wiley Periodicals, Inc.

• Klíčová slova
• International Affective Picture System, Research Domain Criteria, dysphoric mood state, functional magnetic resonance imaging, generalized psychophysiological interaction, negative affect, sex,
• MeSH
• afekt fyziologie   MeSH
• bipolární porucha diagnostické zobrazování   patofyziologie   psychologie   MeSH
• depresivní porucha unipolární diagnostické zobrazování   patofyziologie   psychologie   MeSH
• dospělí MeSH
• faktorová analýza statistická MeSH
• kyslík krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mapování mozku MeSH
• mozek diagnostické zobrazování   patofyziologie   MeSH
• mozkový krevní oběh fyziologie   MeSH
• nervové dráhy diagnostické zobrazování   patofyziologie   MeSH
• pohlavní dimorfismus * MeSH
• psychotické poruchy diagnostické zobrazování   patofyziologie   psychologie   MeSH
• schizofrenie (psychologie) MeSH
• schizofrenie diagnostické zobrazování   patofyziologie   MeSH
• úzkost diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, N.I.H., Extramural MeSH
• srovnávací studie MeSH
• Názvy látek
• kyslík MeSH

OBJECTIVE: Our goal was to model the temporal dynamics of sleep-wake transitions, represented by transitions between rest and activity obtained from actigraphic data, in patients with bipolar disorder using a probabilistic state transition approach. METHODS: We collected actigraphic data for 14 days from 20 euthymic patients with bipolar disorder, who had been characterized clinically, demographically, and with respect to their circadian preferences (chronotype). We processed each activity record to generate a series of transitions in both directions between the states of rest (R) and activity (A) and plotted the estimated transition probabilities (pRA and pAR). Each 24-hour period was also divided into a rest phase consisting of the eight consecutive least active hours in each day and an active phase consisting of the 16 consecutive most active hours in each day. We then calculated separate transition probabilities for each of these phases for each participant. We subsequently modeled the rest phase data to find the best fit for rest-activity transitions using maximum likelihood estimation. We also examined the association of transition probabilities with clinical and demographic variables. RESULTS: The best-fit model for rest-activity transitions during the rest phase was a mixture (bimodal) of exponential functions. Of those patients with rapid cycling, 75% had an evening-type chronotype. Patients with bipolar II disorder taking antidepressants had a lower probability of transitioning back to rest than those not on antidepressants [mean ± SD = 0.050 ± 0.006 versus 0.141 ± 0.058, F(1,15) = 3.40, p < 0.05]. CONCLUSIONS: The dynamics of transitions between rest and activity in bipolar disorder can be accounted for by a mixture (bimodal) of exponential functions. Patients taking antidepressants had a reduced probability of sustaining and returning to sleep.

• Klíčová slova
• actigraphy, activity, antidepressant, bipolar disorder, chronotype, rest, sleep,
• MeSH
• aktigrafie metody   MeSH
• antidepresiva farmakologie   MeSH
• bdění fyziologie   MeSH
• bipolární porucha * farmakoterapie   patofyziologie   psychologie   MeSH
• cirkadiánní hodiny * účinky léků   fyziologie   MeSH
• cirkadiánní rytmus účinky léků   fyziologie   MeSH
• dospělí MeSH
• lidé MeSH
• odpočinek * fyziologie   psychologie   MeSH
• pravděpodobnostní funkce MeSH
• spánek * účinky léků   fyziologie   MeSH
• teoretické modely MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antidepresiva MeSH

PURPOSE OF REVIEW: Type 2 diabetes mellitus (T2DM) negatively affects brain structure and function. Meta-analytical data show that relative to age and sex matched non-psychiatric controls, patients with bipolar disorders have double the risk of T2DM. We review the evidence for association between T2DM and adverse clinical and brain imaging changes in bipolar disorders and summarize studies investigating effects of diabetes treatment on psychiatric and brain outcomes. RECENT FINDINGS: Participants with bipolar disorders and T2DM or insulin resistance demonstrate greater morbidity, chronicity and disability, and lower treatment response to Li. Bipolar disorders complicated by insulin resistance/T2DM are associated with smaller hippocampal and cortical gray matter volumes and lower prefrontal N-acetyl aspartate (neuronal marker). Treatment of T2DM yields preservation of brain gray matter and insulin sensitizers, such as pioglitazone, improve symptoms of depression in unipolar or bipolar disorders. SUMMARY: T2DM or insulin resistance frequently cooccur with bipolar disorders and are associated with negative psychiatric clinical outcomes and compromised brain health. This is clinically concerning, as patients with bipolar disorders have an increased risk of metabolic syndrome and yet often receive suboptimal medical care. At the same time treatment of T2DM and insulin resistance has positive effects on psychiatric and brain outcomes. These findings create a rich agenda for future research, which could enhance psychiatric pharmacopeia and directly impact patient care.

• MeSH
• bipolární porucha krev   metabolismus   patologie   psychologie   MeSH
• deprese farmakoterapie   etiologie   MeSH
• diabetes mellitus 2. typu farmakoterapie   patologie   patofyziologie   psychologie   MeSH
• hypoglykemika terapeutické užití   MeSH
• inzulinová rezistence * MeSH
• lidé MeSH
• mozek patologie   patofyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• hypoglykemika MeSH

OBJECTIVE: This study aimed to examine differences in the clinical presentation of very-early-onset (VEO) and early-onset (EO) bipolar disorder (BD) not fully explored previously. METHODS: We selected two groups of subjects with BD from the Maritime Bipolar Registry based on age at onset of first major mood episode (VEO with onset prior to age 15 years; EO ranging from 15 to 18 years) and compared them with a reference group (onset after 18 years of age). There were 363 subjects (240 with bipolar I disorder and 123 with bipolar II disorder; mean age 44.2 ± 12.8 (SD) years), with 41 subjects in the VEO and 95 in the EO groups. RESULTS: In comparison with the EO and reference groups, more subjects in the VEO group developed major depression as an index episode (88% for the VEO group versus 61% for the EO group and 54% for the reference group), and had an unremitting clinical course (65% versus 42% and 42%, respectively), rapid cycling (54% versus 34% and 28%, respectively), and comorbid attention-deficit hyperactivity disorder (17% versus 1% and 3%, respectively); a higher proportion of the VEO group had first-degree relatives with affective disorders compared with the EO and reference groups (0.41 versus 0.32 and 0.29, respectively), and they had lower scores on the Global Assessment of Functioning scale (mean scores of 64 versus 70 and 70). Overall, the EO group was similar to the reference group on most measures, except for increased suicidal behavior VEO 53%, EO 44% and reference group 25%). The results of polychotomous logistic regression also support the view that VEO BD represents a rather specific subtype of BD. CONCLUSIONS: Our results suggest the recognized correlates of early-onset BD may be driven by subjects at the lowest end of the age at onset spectrum.

• Klíčová slova
• bipolar disorder, childhood ADHD, early course, early onset, first mood episode, rapid cycling,
• MeSH
• bipolární porucha * diagnóza   epidemiologie   psychologie   MeSH
• depresivní porucha unipolární diagnóza   epidemiologie   psychologie   MeSH
• dospělí MeSH
• hyperkinetická porucha * diagnóza   epidemiologie   psychologie   MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• poruchy nálady diagnóza   epidemiologie   psychologie   MeSH
• psychiatrické posuzovací škály MeSH
• psychopatologie MeSH
• rodina psychologie   MeSH
• věk při počátku nemoci MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Kanada epidemiologie   MeSH

OBJECTIVES: Bipolar disorder is a common psychiatric disease characterized by mood disturbances with alternating episodes of mania and depression. Moreover, disturbances in the sleep/wake cycle are prevalent. We tested a hypothesis that the function of the circadian system, which drives the sleep/wake cycle, may differ in patients with bipolar disorder depending on whether they are experiencing an episode of mania or depression. METHODS: To assess the functional state of the central circadian clock, daily profiles of melatonin levels in saliva were determined. The functional state of the peripheral clocks was assessed by determining daily profiles of Per1 and Nr1d1 clock gene expression in buccal mucosa cells. Sixteen patients with bipolar disorder in a manic episode, 22 patients in a depressive episode, and 19 healthy control subjects provided samples at regular intervals during a 24-hour cycle. RESULTS: During episodes of mania, the daily profiles of melatonin differed compared with healthy controls and patients in an episode of depression, mainly due to elevated melatonin levels during the daytime. No difference was found between melatonin profiles of control subjects and patients in depression. The Per1 and Nr1d1 profiles were advanced in patients in mania compared with those in depression. Compared with controls, a trend toward an advance was apparent in the profiles of patients during an episode of mania but not depression. The amplitude of the Nr1d1 expression profile was higher in mania than in depression. CONCLUSIONS: The data revealed differences in the functional state of the circadian system in patients with bipolar disorder depending on whether they were experiencing a manic or a depressive episode.

• Klíčová slova
• Nr1d1, Per1, bipolar disorder, circadian, clock gene, melatonin,
• MeSH
• bipolární porucha genetika   patofyziologie   psychologie   MeSH
• chronobiologické poruchy genetika   patofyziologie   psychologie   MeSH
• cirkadiánní hodiny genetika   MeSH
• cirkadiánní proteiny Period genetika   MeSH
• cirkadiánní rytmus genetika   MeSH
• dospělí MeSH
• jaderné receptory - podrodina 1, skupina D, člen 1 genetika   MeSH
• lidé středního věku MeSH
• lidé MeSH
• melatonin metabolismus   MeSH
• messenger RNA metabolismus   MeSH
• prevalence MeSH
• sliny chemie   MeSH
• studie případů a kontrol MeSH
• transkriptom MeSH
• ústní sliznice metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• cirkadiánní proteiny Period MeSH
• jaderné receptory - podrodina 1, skupina D, člen 1 MeSH
• melatonin MeSH
• messenger RNA MeSH
• NR1D1 protein, human MeSH Prohlížeč
• PER1 protein, human MeSH Prohlížeč