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2. Characteristics of Adults Hospitalized for a Major Depressive Disorder: Results from the Multicenter OASIS-D Study

Author

Correll, C. U., primary, Bermpohl, F., additional, Schoofs, N., additional, Bathe-Peters, R., additional, Pfeifer, K., additional, Falkai, P., additional, Schüle, C., additional, Pan-Montojo, F., additional, Wang, E. Y. M., additional, Reif, A., additional, Reif-Leonhard, C., additional, Schillo, S., additional, Getty, P., additional, Adli, M., additional, Papenfuß, R., additional, Jessen, F., additional, Salimi-Dafsari, F., additional, Bauer, M., additional, Lewitzka, U., additional, Otte, C., additional, Graumann, L., additional, Piber, D., additional, Weyn-Banningh, S., additional, Meyer-Lindenberg, A., additional, Böhringer, A., additional, Heuer, F., additional, and Nöhles, V. B., additional

Published
2023
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4. Influence of birth cohort on age of onset cluster analysis in bipolar I disorder

Author

Bauer, M., Glenn, T., Alda, M., Andreassen, O.A., Angelopoulos, E., Ardau, R., Baethge, C., Bauer, R., Bellivier, F., Belmaker, R.H., Berk, M., Bjella, T.D., Bossini, L., Bersudsky, Y., Cheung, E.Y.W., Conell, J., Del Zompo, M., Dodd, S., Etain, B., Fagiolini, A., Frye, M.A., Fountoulakis, K.N., Garneau-Fournier, J., Gonzalez-Pinto, A., Harima, H., Hassel, S., Henry, C., Iacovides, A., Isometsä, E.T., Kapczinski, F., Kliwicki, S., König, B., Krogh, R., Kunz, M., Lafer, B., Larsen, E.R., Lewitzka, U., Lopez-Jaramillo, C., MacQueen, G., Manchia, M., Marsh, W., Martinez-Cengotitabengoa, M., Melle, I., Monteith, S., Morken, G., Munoz, R., Nery, F.G., O’Donovan, C., Osher, Y., Pfennig, A., Quiroz, D., Ramesar, R., Rasgon, N., Reif, A., Ritter, P., Rybakowski, J.K., Sagduyu, K., Scippa, A.M., Severus, E., Simhandl, C., Stein, D.J., Strejilevich, S., Hatim Sulaiman, A., Suominen, K., Tagata, H., Tatebayashi, Y., Torrent, C., Vieta, E., Viswanath, B., Wanchoo, M.J., Zetin, M., and Whybrow, P.C.

Published
2015
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6. Solar insolation in springtime influences age of onset of bipolar I disorder

Author

Bauer, M., Glenn, T., Alda, M., Aleksandrovich, M. A., Andreassen, O. A., Angelopoulos, E., Ardau, R., Ayhan, Y., Baethge, C., Bharathram, S. R., Bauer, R., Baune, B. T., Becerra‐Palars, C., Bellivier, F., Belmaker, R. H., Berk, M., Bersudsky, Y., Bicakci, Ş., Birabwa‐Oketcho, H., Bjella, T. D., Bossini, L., Cabrera, J., Cheung, E. Y. W., Del Zompo, M., Dodd, S., Donix, M., Etain, B., Fagiolini, A., Fountoulakis, K. N., Frye, M. A., Gonzalez‐Pinto, A., Gottlieb, J. F., Grof, P., Harima, H., Henry, C., Isometsä, E. T., Janno, S., Kapczinski, F., Kardell, M., Khaldi, S., Kliwicki, S., König, B., Kot, T. L., Krogh, R., Kunz, M., Lafer, B., Landén, M., Larsen, E. R., Lewitzka, U., Licht, R. W., Lopez‐Jaramillo, C., MacQueen, G., Manchia, M., Marsh, W., Martinez‐Cengotitabengoa, M., Melle, I., Meza‐Urzúa, F., Yee Ming, M., Monteith, S., Morken, G., Mosca, E., Munoz, R., Mythri, S. V., Nacef, F., Nadella, R. K., Nery, F. G., Nielsen, R. E., OʼDonovan, C., Omrani, A., Osher, Y., Østermark Sørensen, H., Ouali, U., Pica Ruiz, Y., Pilhatsch, M., Pinna, M., da Ponte, F. D. R., Quiroz, D., Ramesar, R., Rasgon, N., Reddy, M. S., Reif, A., Ritter, P., Rybakowski, J. K., Sagduyu, K., Scippa, Â. M., Severus, E., Simhandl, C., Stein, D. J., Strejilevich, S., Subramaniam, M., Sulaiman, A. H., Suominen, K., Tagata, H., Tatebayashi, Y., Tondo, L., Torrent, C., Vaaler, A. E., Veeh, J., Vieta, E., Viswanath, B., Yoldi‐Negrete, M., Zetin, M., Zgueb, Y., and Whybrow, P. C.

Published
2017
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14. Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Author

Bauer, M. Glenn, T. Achtyes, E.D. Alda, M. Agaoglu, E. Altınbaş, K. Andreassen, O.A. Angelopoulos, E. Ardau, R. Vares, E.A. Aydin, M. Ayhan, Y. Baethge, C. Bauer, R. Baune, B.T. Balaban, C. Becerra-Palars, C. Behere, A.P. Behere, P.B. Belete, H. Belete, T. Belizario, G.O. Bellivier, F. Belmaker, R.H. Benedetti, F. Berk, M. Bersudsky, Y. Bicakci, Ş. Birabwa-Oketcho, H. Bjella, T.D. Brady, C. Cabrera, J. Cappucciati, M. Castro, A.M.P. Chen, W.-L. Cheung, E.Y.W. Chiesa, S. Crowe, M. Cuomo, A. Dallaspezia, S. Del Zompo, M. Desai, P. Dodd, S. Donix, M. Etain, B. Fagiolini, A. Fellendorf, F.T. Ferensztajn-Rochowiak, E. Fiedorowicz, J.G. Fountoulakis, K.N. Frye, M.A. Geoffroy, P.A. Gonzalez-Pinto, A. Gottlieb, J.F. Grof, P. Haarman, B.C.M. Harima, H. Hasse-Sousa, M. Henry, C. Høffding, L. Houenou, J. Imbesi, M. Isometsä, E.T. Ivkovic, M. Janno, S. Johnsen, S. Kapczinski, F. Karakatsoulis, G.N. Kardell, M. Kessing, L.V. Kim, S.J. König, B. Kot, T.L. Koval, M. Kunz, M. Lafer, B. Landén, M. Larsen, E.R. Lenger, M. Lewitzka, U. Licht, R.W. Lopez-Jaramillo, C. MacKenzie, A. Madsen, H.Ø. Madsen, S.A.K.A. Mahadevan, J. Mahardika, A. Manchia, M. Marsh, W. Martinez-Cengotitabengoa, M. Martiny, K. Mashima, Y. McLoughlin, D.M. Meesters, Y. Melle, I. Meza-Urzúa, F. Ming, M.Y. Monteith, S. Moorthy, M. Morken, G. Mosca, E. Mozzhegorov, A.A. Munoz, R. Mythri, S.V. Nacef, F. Nadella, R.K. Nakanotani, T. Nielsen, R.E. O‘Donovan, C. Omrani, A. Osher, Y. Ouali, U. Pantovic-Stefanovic, M. Pariwatcharakul, P. Petite, J. Pfennig, A. Ruiz, Y.P. Pilhatsch, M. Pinna, M. Pompili, M. Porter, R. Quiroz, D. Rabelo-da-Ponte, F.D. Ramesar, R. Rasgon, N. Ratta-apha, W. Ratzenhofer, M. Redahan, M. Reddy, M.S. Reif, A. Reininghaus, E.Z. Richards, J.G. Ritter, P. Rybakowski, J.K. Sathyaputri, L. Scippa, Â.M. Simhandl, C. Severus, E. Smith, D. Smith, J. Stackhouse, P.W., Jr. Stein, D.J. Stilwell, K. Strejilevich, S. Su, K.-P. Subramaniam, M. Sulaiman, A.H. Suominen, K. Tanra, A.J. Tatebayashi, Y. Teh, W.L. Tondo, L. Torrent, C. Tuinstra, D. Uchida, T. Vaaler, A.E. Veeh, J. Vieta, E. Viswanath, B. Yoldi-Negrete, M. Yalcinkaya, O.K. Young, A.H. Zgueb, Y. Whybrow, P.C.

Abstract

Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed. © 2021, The Author(s).

Published
2021

15. Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Author

Bauer, M, Glenn, T, Achtyes, ED, Alda, M, Agaoglu, E, Altınbaş, K, Andreassen, OA, Angelopoulos, E, Ardau, R, Vares, EA, Aydin, M, Ayhan, Y, Baethge, C, Bauer, R, Baune, BT, Balaban, C, Becerra-Palars, C, Behere, AP, Behere, PB, Belete, H, Belete, T, Belizario, GO, Bellivier, F, Belmaker, RH, Benedetti, F, Berk, Michael, Bersudsky, Y, Bicakci, Ş, Birabwa-Oketcho, H, Bjella, TD, Brady, C, Cabrera, J, Cappucciati, M, Castro, AMP, Chen, WL, Cheung, EYW, Chiesa, S, Crowe, M, Cuomo, A, Dallaspezia, S, Del Zompo, M, Desai, P, Dodd, Seetal, Donix, M, Etain, B, Fagiolini, A, Fellendorf, FT, Ferensztajn-Rochowiak, E, Fiedorowicz, JG, Fountoulakis, KN, Frye, MA, Geoffroy, PA, Gonzalez-Pinto, A, Gottlieb, JF, Grof, P, Haarman, BCM, Harima, H, Hasse-Sousa, M, Henry, C, Høffding, L, Houenou, J, Imbesi, M, Isometsä, ET, Ivkovic, M, Janno, S, Johnsen, S, Kapczinski, F, Karakatsoulis, GN, Kardell, M, Kessing, LV, Kim, SJ, König, B, Kot, TL, Koval, M, Kunz, M, Lafer, B, Landén, M, Larsen, ER, Lenger, M, Lewitzka, U, Licht, RW, Lopez-Jaramillo, C, MacKenzie, A, Madsen, HØ, Madsen, SAKA, Mahadevan, J, Mahardika, A, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Martiny, K, Mashima, Y, McLoughlin, DM, Meesters, Y, Melle, I, Meza-Urzúa, F, Ming, MY, Monteith, S, Moorthy, M, Morken, G, Bauer, M, Glenn, T, Achtyes, ED, Alda, M, Agaoglu, E, Altınbaş, K, Andreassen, OA, Angelopoulos, E, Ardau, R, Vares, EA, Aydin, M, Ayhan, Y, Baethge, C, Bauer, R, Baune, BT, Balaban, C, Becerra-Palars, C, Behere, AP, Behere, PB, Belete, H, Belete, T, Belizario, GO, Bellivier, F, Belmaker, RH, Benedetti, F, Berk, Michael, Bersudsky, Y, Bicakci, Ş, Birabwa-Oketcho, H, Bjella, TD, Brady, C, Cabrera, J, Cappucciati, M, Castro, AMP, Chen, WL, Cheung, EYW, Chiesa, S, Crowe, M, Cuomo, A, Dallaspezia, S, Del Zompo, M, Desai, P, Dodd, Seetal, Donix, M, Etain, B, Fagiolini, A, Fellendorf, FT, Ferensztajn-Rochowiak, E, Fiedorowicz, JG, Fountoulakis, KN, Frye, MA, Geoffroy, PA, Gonzalez-Pinto, A, Gottlieb, JF, Grof, P, Haarman, BCM, Harima, H, Hasse-Sousa, M, Henry, C, Høffding, L, Houenou, J, Imbesi, M, Isometsä, ET, Ivkovic, M, Janno, S, Johnsen, S, Kapczinski, F, Karakatsoulis, GN, Kardell, M, Kessing, LV, Kim, SJ, König, B, Kot, TL, Koval, M, Kunz, M, Lafer, B, Landén, M, Larsen, ER, Lenger, M, Lewitzka, U, Licht, RW, Lopez-Jaramillo, C, MacKenzie, A, Madsen, HØ, Madsen, SAKA, Mahadevan, J, Mahardika, A, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Martiny, K, Mashima, Y, McLoughlin, DM, Meesters, Y, Melle, I, Meza-Urzúa, F, Ming, MY, Monteith, S, Moorthy, M, and Morken, G

Abstract

Abstract Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, a

Published
2021

17. German S3 guidelines on bipolar disorders-first update 2019 What is new in pharmacotherapy?

Author

Bschor, T., Baethge, C., Grunze, H., Lewitzka, U., Scherk, H., Severus, E., Bauer, M., Bschor, T., Baethge, C., Grunze, H., Lewitzka, U., Scherk, H., Severus, E., and Bauer, M.

Abstract

Background German S3 guidelines are subject to the highest methodological standards. This includes that they are only valid for a certain time period. Following the first edition in 2012 the first update of the S3 guidelines on bipolar disorder has now been published (2019). Objective What has changed in the field of pharmacological recommendations comparing the first edition with the update in 2019? Material and methods Comparison of the 1st edition from 2012 with the update from 2019 of the S3 guidelines for the diagnostics and treatment of bipolar disorders. Results The three principle treatment targets of acute treatment of bipolar depression, acute treatment of mania and phase prophylaxis (maintenance treatment) can be distinguished. For acute treatment of bipolar depression, for the first time a medication has received a level A recommendation: quetiapine. For the acute treatment of mania, several drugs are still recommended with the same level of recommendation (B). Asenapine has been added as the tenth substance. Lithium is still the only drug with a level A recommendation for maintenance and prophylactic treatment and is also the only drug approved for this indication without restrictions. A new recommendation is that in the absence of contraindications, phase prophylaxis with a serum level of at least 0.6x202f;mmol/l should be carried out. With a B recommendation, quetiapine has been added to the drugs for phase prophylactic treatment. Conclusion The S3 guidelines make recommendations at the highest scientific level. In view of these findings, lithium is clearly underutilized for maintenance therapy. In the absence of clear contraindications (advanced renal insufficiency), every patient with bipolar disease should be given the chance of lithium prophylaxis for an adequately long period.

Published
2020

23. Association between solar insolation and a history of suicide attempts in bipolar I disorder

Author

Bauer, M. Glenn, T. Alda, M. Andreassen, O.A. Angelopoulos, E. Ardau, R. Ayhan, Y. Baethge, C. Bauer, R. Baune, B.T. Becerra-Palars, C. Bellivier, F. Belmaker, R.H. Berk, M. Bersudsky, Y. Bicakci, Ş. Birabwa-Oketcho, H. Bjella, T.D. Cabrera, J. Wo Cheung, E.Y. Del Zompo, M. Dodd, S. Donix, M. Etain, B. Fagiolini, A. Fountoulakis, K.N. Frye, M.A. Gonzalez-Pinto, A. Gottlieb, J.F. Grof, P. Harima, H. Henry, C. Isometsä, E.T. Janno, S. Kapczinski, F. Kardell, M. Khaldi, S. Kliwicki, S. König, B. Kot, T.L. Krogh, R. Kunz, M. Lafer, B. Landén, M. Larsen, E.R. Lewitzka, U. Licht, R.W. Lopez-Jaramillo, C. MacQueen, G. Manchia, M. Marsh, W. Martinez-Cengotitabengoa, M. Melle, I. Meza-Urzúa, F. Ming, M.Y. Monteith, S. Morken, G. Mosca, E. Mozzhegorov, A.A. Munoz, R. Mythri, S.V. Nacef, F. Nadella, R.K. Nery, F.G. Nielsen, R.E. O'Donovan, C. Omrani, A. Osher, Y. Sørensen, H.Ø. Ouali, U. Ruiz, Y.P. Pilhatsch, M. Pinna, M. da Ponte, F.D.R. Quiroz, D. Ramesar, R. Rasgon, N. Reddy, M.S. Reif, A. Ritter, P. Rybakowski, J.K. Sagduyu, K. Raghuraman, B.S. Scippa, Â.M. Severus, E. Simhandl, C. Stackhouse, P.W., Jr. Stein, D.J. Strejilevich, S. Subramaniam, M. Sulaiman, A.H. Suominen, K. Tagata, H. Tatebayashi, Y. Tondo, L. Torrent, C. Vaaler, A.E. Vares, E. Veeh, J. Vieta, E. Viswanath, B. Yoldi-Negrete, M. Zetin, M. Zgueb, Y. Whybrow, P.C.

Abstract

In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p < 0.01). In summary, living in locations with large changes in solar insolation between winter and summer may be associated with increased suicide attempts in patients with bipolar disorder. Further investigation of the impacts of solar insolation on the course of bipolar disorder is needed. © 2019 Elsevier Ltd

Published
2019

26. Internet use by older adults with bipolar disorder: international survey results

Author

Bauer, R, Glenn, T, Strejilevich, S, Conell, J, Alda, M, Ardau, R, Baune, BT, Berk, M, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Castro, AMP, Cheung, EYW, Chillotti, C, Choppin, S, Cuomo, A, Del Zompo, M, Dias, R, Dodd, S, Duffy, A, Etain, B, Fagiolini, A, Fernandez Hernandez, M, Garnham, J, Geddes, J, Gildebro, J, Gitlin, MJ, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Lund, AH, Kapur, V, Kunigiri, G, Lafer, B, Larsen, ER, Lewitzka, U, Licht, RW, Misiak, B, Piotrowski, P, Miranda-Scippa, A, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Veeh, J, Vieta, E, Vinberg, M, Viswanath, B, Zetin, M, Whybrow, PC, Bauer, M, Bauer, R, Glenn, T, Strejilevich, S, Conell, J, Alda, M, Ardau, R, Baune, BT, Berk, M, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Castro, AMP, Cheung, EYW, Chillotti, C, Choppin, S, Cuomo, A, Del Zompo, M, Dias, R, Dodd, S, Duffy, A, Etain, B, Fagiolini, A, Fernandez Hernandez, M, Garnham, J, Geddes, J, Gildebro, J, Gitlin, MJ, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Lund, AH, Kapur, V, Kunigiri, G, Lafer, B, Larsen, ER, Lewitzka, U, Licht, RW, Misiak, B, Piotrowski, P, Miranda-Scippa, A, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Veeh, J, Vieta, E, Vinberg, M, Viswanath, B, Zetin, M, Whybrow, PC, and Bauer, M

Abstract

BACKGROUND: The world population is aging and the number of older adults with bipolar disorder is increasing. Digital technologies are viewed as a framework to improve care of older adults with bipolar disorder. This analysis quantifies Internet use by older adults with bipolar disorder as part of a larger survey project about information seeking. METHODS: A paper-based survey about information seeking by patients with bipolar disorder was developed and translated into 12 languages. The survey was anonymous and completed between March 2014 and January 2016 by 1222 patients in 17 countries. All patients were diagnosed by a psychiatrist. General estimating equations were used to account for correlated data. RESULTS: Overall, 47% of older adults (age 60 years or older) used the Internet versus 87% of younger adults (less than 60 years). More education and having symptoms that interfered with regular activities increased the odds of using the Internet, while being age 60 years or older decreased the odds. Data from 187 older adults and 1021 younger adults were included in the analysis excluding missing values. CONCLUSIONS: Older adults with bipolar disorder use the Internet much less frequently than younger adults. Many older adults do not use the Internet, and technology tools are suitable for some but not all older adults. As more health services are only available online, and more digital tools are developed, there is concern about growing health disparities based on age. Mental health experts should participate in determining the appropriate role for digital tools for older adults with bipolar disorder.

Published
2018

27. Solar insolation in springtime influences age of onset of bipolar I disorder

Author

Bauer, M. Glenn, T. Alda, M. Aleksandrovich, M.A. Andreassen, O.A. Angelopoulos, E. Ardau, R. Ayhan, Y. Baethge, C. Bharathram, S.R. Bauer, R. Baune, B.T. Becerra-Palars, C. Bellivier, F. Belmaker, R.H. Berk, M. Bersudsky, Y. Bicakci, Ş. Birabwa-Oketcho, H. Bjella, T.D. Bossini, L. Cabrera, J. Cheung, E.Y.W. Del Zompo, M. Dodd, S. Donix, M. Etain, B. Fagiolini, A. Fountoulakis, K.N. Frye, M.A. Gonzalez-Pinto, A. Gottlieb, J.F. Grof, P. Harima, H. Henry, C. Isometsä, E.T. Janno, S. Kapczinski, F. Kardell, M. Khaldi, S. Kliwicki, S. König, B. Kot, T.L. Krogh, R. Kunz, M. Lafer, B. Landén, M. Larsen, E.R. Lewitzka, U. Licht, R.W. Lopez-Jaramillo, C. MacQueen, G. Manchia, M. Marsh, W. Martinez-Cengotitabengoa, M. Melle, I. Meza-Urzúa, F. Yee Ming, M. Monteith, S. Morken, G. Mosca, E. Munoz, R. Mythri, S.V. Nacef, F. Nadella, R.K. Nery, F.G. Nielsen, R.E. O'Donovan, C. Omrani, A. Osher, Y. Østermark Sørensen, H. Ouali, U. Pica Ruiz, Y. Pilhatsch, M. Pinna, M. da Ponte, F.D.R. Quiroz, D. Ramesar, R. Rasgon, N. Reddy, M.S. Reif, A. Ritter, P. Rybakowski, J.K. Sagduyu, K. Scippa, Â.M. Severus, E. Simhandl, C. Stein, D.J. Strejilevich, S. Subramaniam, M. Sulaiman, A.H. Suominen, K. Tagata, H. Tatebayashi, Y. Tondo, L. Torrent, C. Vaaler, A.E. Veeh, J. Vieta, E. Viswanath, B. Yoldi-Negrete, M. Zetin, M. Zgueb, Y. Whybrow, P.C.

Abstract

Objective: To confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder. Method: Data were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth-cohort, family history, polarity of first episode and country physician density. Results: There was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth-cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth-cohort (all estimated coefficients P < 0.001). Conclusion: A large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LED lighting, mobile devices backlit with LEDs) may influence adaptability to a springtime circadian challenge. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Published
2017

28. Antidepressant sales and regional variations of suicide mortality in Germany

Author

Blüml, V, Helbich, M., Mayr, M, Turnwald, R, Vyssoki, B, Lewitzka, U, Hartung, S, Plener, P, Fegert, J, Kapusta, N, Blüml, V, Helbich, M., Mayr, M, Turnwald, R, Vyssoki, B, Lewitzka, U, Hartung, S, Plener, P, Fegert, J, and Kapusta, N

Abstract

Suicides account for over one million deaths per year worldwide with depression among the most important risk factors. Epidemiological research into the relationship between antidepressant utilization and suicide mortality has shown heterogeneous and contradictory results. Different methodological approaches and limitations could at least partially explain varying results. This is the first study assessing the association of suicide mortality and antidepressant sales across Germany using complex statistical approaches in order to control for possible confounding factors including spatial dependency of data. German suicide counts were analyzed on a district level (n = 402) utilizing ecological Poisson regressions within a hierarchical Bayesian framework. Due to significant spatial effects between adjacent districts spatial models were calculated in addition to a baseline non-spatial model. Models were adjusted for several confounders including socioeconomic variables, quality of psychosocial care, and depression prevalence. Separate analyses were performed for Eastern and Western Germany and for different classes of antidepressants (SSRIs and TCAs). Overall antidepressant sales were significantly negatively associated with suicide mortality in the non-spatial baseline model, while after adjusting for spatially structured and unstructured effects the association turned out to be insignificant. In sub-analyses, analogue results were found for SSRIs and TCAs separately. Suicide risk shows a distinct heterogeneous pattern with a pronounced relative risk in Southeast Germany. In conclusion, the results reflect the heterogeneous findings of previous studies on the association between suicide mortality and antidepressant sales and point to the complexity of this hypothesized link. Furthermore, the findings support tailored suicide preventive efforts within high risk areas.

Published
2017

29. Antidepressant sales and regional variations of suicide mortality in Germany

Author

Social Urban Transitions, Blüml, V, Helbich, M., Mayr, M, Turnwald, R, Vyssoki, B, Lewitzka, U, Hartung, S, Plener, P, Fegert, J, Kapusta, N, Social Urban Transitions, Blüml, V, Helbich, M., Mayr, M, Turnwald, R, Vyssoki, B, Lewitzka, U, Hartung, S, Plener, P, Fegert, J, and Kapusta, N

Published
2017

30. Erratum to: online information seeking by patients with bipolar disorder: results from an international multisite survey

Author

Conell, J, Bauer, R, Glenn, T, Alda, M, Ardau, R, Baune, BT, Berk, Michael, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Bossini, L, Paredes Castro, AM, Cheung, EYW, Chillotti, C, Choppin, S, Del Zompo, M, Dias, R, Dodd, Seetal, Duffy, A, Etain, B, Fagiolini, A, Garnham, J, Geddes, J, Gildebro, J, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Kapur, V, Kunigiri, G, Lafer, B, Lam, C, Larsen, ER, Lewitzka, U, Licht, RW, Lund, AH, Misiak, B, Piotrowski, P, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Scippa, Â, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Vieta, E, Vinberg, M, Viswanath, B, Volkert, J, Zetin, M, Zorrilla, I, Whybrow, PC, Bauer, M, Conell, J, Bauer, R, Glenn, T, Alda, M, Ardau, R, Baune, BT, Berk, Michael, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Bossini, L, Paredes Castro, AM, Cheung, EYW, Chillotti, C, Choppin, S, Del Zompo, M, Dias, R, Dodd, Seetal, Duffy, A, Etain, B, Fagiolini, A, Garnham, J, Geddes, J, Gildebro, J, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Kapur, V, Kunigiri, G, Lafer, B, Lam, C, Larsen, ER, Lewitzka, U, Licht, RW, Lund, AH, Misiak, B, Piotrowski, P, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Scippa, Â, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Vieta, E, Vinberg, M, Viswanath, B, Volkert, J, Zetin, M, Zorrilla, I, Whybrow, PC, and Bauer, M

Published
2017

31. Solar insolation in springtime influences age of onset of bipolar I disorder

Author

Bauer, M, Glenn, T, Alda, M, Aleksandrovich, MA, Andreassen, OA, Angelopoulos, E, Ardau, R, Ayhan, Y, Baethge, C, Bharathram, SR, Bauer, R, Baune, BT, Becerra-Palars, C, Bellivier, F, Belmaker, RH, Berk, M, Bersudsky, Y, Bicakci, S, Birabwa-Oketcho, H, Bjella, TD, Bossini, L, Cabrera, J, Cheung, EYW, Del Zompo, M, Dodd, S, Donix, M, Etain, B, Fagiolini, A, Fountoulakis, KN, Frye, MA, Gonzalez-Pinto, A, Gottlieb, JF, Grof, P, Harima, H, Henry, C, Isometsae, ET, Janno, S, Kapczinski, F, Kardell, M, Khaldi, S, Kliwicki, S, Koenig, B, Kot, TL, Krogh, R, Kunz, M, Lafer, B, Landen, M, Larsen, ER, Lewitzka, U, Licht, RW, Lopez-Jaramillo, C, MacQueen, G, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Melle, I, Meza-Urzua, F, Yee Ming, M, Monteith, S, Morken, G, Mosca, E, Munoz, R, Mythri, SV, Nacef, F, Nadella, RK, Nery, FG, Nielsen, RE, O'Donovan, C, Omrani, A, Osher, Y, Ostermark Sorensen, H, Ouali, U, Pica Ruiz, Y, Pilhatsch, M, Pinna, M, da Ponte, FDR, Quiroz, D, Ramesar, R, Rasgon, N, Reddy, MS, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Scippa, AM, Severus, E, Simhandl, C, Stein, DJ, Strejilevich, S, Subramaniam, M, Sulaiman, AH, Suominen, K, Tagata, H, Tatebayashi, Y, Tondo, L, Torrent, C, Vaaler, AE, Veeh, J, Vieta, E, Viswanath, B, Yoldi-Negrete, M, Zetin, M, Zgueb, Y, Whybrow, PC, Bauer, M, Glenn, T, Alda, M, Aleksandrovich, MA, Andreassen, OA, Angelopoulos, E, Ardau, R, Ayhan, Y, Baethge, C, Bharathram, SR, Bauer, R, Baune, BT, Becerra-Palars, C, Bellivier, F, Belmaker, RH, Berk, M, Bersudsky, Y, Bicakci, S, Birabwa-Oketcho, H, Bjella, TD, Bossini, L, Cabrera, J, Cheung, EYW, Del Zompo, M, Dodd, S, Donix, M, Etain, B, Fagiolini, A, Fountoulakis, KN, Frye, MA, Gonzalez-Pinto, A, Gottlieb, JF, Grof, P, Harima, H, Henry, C, Isometsae, ET, Janno, S, Kapczinski, F, Kardell, M, Khaldi, S, Kliwicki, S, Koenig, B, Kot, TL, Krogh, R, Kunz, M, Lafer, B, Landen, M, Larsen, ER, Lewitzka, U, Licht, RW, Lopez-Jaramillo, C, MacQueen, G, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Melle, I, Meza-Urzua, F, Yee Ming, M, Monteith, S, Morken, G, Mosca, E, Munoz, R, Mythri, SV, Nacef, F, Nadella, RK, Nery, FG, Nielsen, RE, O'Donovan, C, Omrani, A, Osher, Y, Ostermark Sorensen, H, Ouali, U, Pica Ruiz, Y, Pilhatsch, M, Pinna, M, da Ponte, FDR, Quiroz, D, Ramesar, R, Rasgon, N, Reddy, MS, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Scippa, AM, Severus, E, Simhandl, C, Stein, DJ, Strejilevich, S, Subramaniam, M, Sulaiman, AH, Suominen, K, Tagata, H, Tatebayashi, Y, Tondo, L, Torrent, C, Vaaler, AE, Veeh, J, Vieta, E, Viswanath, B, Yoldi-Negrete, M, Zetin, M, Zgueb, Y, and Whybrow, PC

Abstract

OBJECTIVE: To confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder. METHOD: Data were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth-cohort, family history, polarity of first episode and country physician density. RESULTS: There was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth-cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth-cohort (all estimated coefficients P < 0.001). CONCLUSION: A large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LED lighting, mobile devices backlit with LEDs) may influence adaptability to a springtime circadian challenge.

Published
2017

32. Online information seeking by patients with bipolar disorder: results from an international multisite survey (vol 4, pg 1, 2016)

Author

Conell, J, Bauer, R, Glenn, T, Alda, M, Ardau, R, Baune, BT, Berk, M, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Bossini, L, Castro, AMP, Cheung, EYW, Chillotti, C, Choppin, S, Del Zompo, M, Dias, R, Dodd, S, Duffy, A, Etain, B, Fagiolini, A, Garnham, J, Geddes, J, Gildebro, J, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Kapur, V, Kunigiri, G, Lafer, B, Lam, C, Larsen, ER, Lewitzka, U, Licht, R, Lund, AH, Misiak, B, Piotrowski, P, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Scippa, AM, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Vieta, E, Vinberg, M, Viswanath, B, Volkert, J, Zetin, M, Zorrilla, I, Whybrow, PC, Bauer, M, Conell, J, Bauer, R, Glenn, T, Alda, M, Ardau, R, Baune, BT, Berk, M, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Bossini, L, Castro, AMP, Cheung, EYW, Chillotti, C, Choppin, S, Del Zompo, M, Dias, R, Dodd, S, Duffy, A, Etain, B, Fagiolini, A, Garnham, J, Geddes, J, Gildebro, J, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Kapur, V, Kunigiri, G, Lafer, B, Lam, C, Larsen, ER, Lewitzka, U, Licht, R, Lund, AH, Misiak, B, Piotrowski, P, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Scippa, AM, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Vieta, E, Vinberg, M, Viswanath, B, Volkert, J, Zetin, M, Zorrilla, I, Whybrow, PC, and Bauer, M

Published
2017

34. Influence of birth cohort on age of onset cluster analysis in bipolar I disorder

Author

Bauer, M. Glenn, T. Alda, M. Andreassen, O. A. and Angelopoulos, E. Ardau, R. Baethge, C. Bauer, R. and Bellivier, F. Belmaker, R. H. Berk, M. Bjella, T. D. and Bossini, L. Bersudsky, Y. Cheung, E. Y. W. Conell, J. and Del Zompo, M. Dodd, S. Etain, B. Fagiolini, A. Frye, M. A. Fountoulakis, K. N. Garneau-Fournier, J. Gonzalez-Pinto, A. Harima, H. Hassel, S. Henry, C. Iacovides, A. and Isometsa, E. T. Kapczinski, F. Kliwicki, S. Koenig, B. and Krogh, R. Kunz, M. Lafer, B. Larsen, E. R. Lewitzka, U. and Lopez-Jaramillo, C. MacQueen, G. Manchia, M. Marsh, W. and Martinez-Cengotitabengoa, M. Melle, I. Monteith, S. and Morken, G. Munoz, R. Nery, F. G. O'Donovan, C. Osher, Y. and Pfennig, A. Quiroz, D. Ramesar, R. Rasgon, N. Reif, A. Ritter, P. Rybakowski, J. K. Sagduyu, K. Scippa, A. M. Severus, E. Simhandl, C. Stein, D. J. Strejilevich, S. Sulaiman, A. Hatim Suominen, K. Tagata, H. and Tatebayashi, Y. Torrent, C. Vieta, E. Viswanath, B. and Wanchoo, M. J. Zetin, M. Whybrow, P. C.

Abstract

Purpose: Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onset, using a large, international database. Methods: The database includes 4037 patients with a diagnosis of bipolar I disorder, previously collected at 36 collection sites in 23 countries. Generalized estimating equations (GEE) were used to adjust the data for country median age, and in some models, birth cohort. Model-based clustering (mixture analysis) was then performed on the age of onset data using the residuals. Clinical variables in subgroups were compared. Results: There was a strong birth cohort effect. Without adjusting for the birth cohort, three subgroups were found by clustering. After adjusting for the birth cohort or when considering only those born after 1959, two subgroups were found. With results of either two or three subgroups, the youngest subgroup was more likely to have a family history of mood disorders and a first episode with depressed polarity. However, without adjusting for birth cohort (three subgroups), family history and polarity of the first episode could not be distinguished between the middle and oldest subgroups. Conclusion: These results using international data confirm prior findings using single country data, that there are subgroups of bipolar I disorder based on the age of onset, and that there is a birth cohort effect. Including the birth cohort adjustment altered the number and characteristics of subgroups detected when clustering by age of onset. Further investigation is needed to determine if combining both approaches will identify subgroups that are more useful for research. (C) 2014 Elsevier Masson SAS. All rights reserved.

Published
2015

35. Online information seeking by patients with bipolar disorder: results from an international multisite survey

Author

Conell, J, Bauer, R, Glenn, T, Alda, M, Ardau, R, Baune, BT, Berk, M, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Bossini, L, Castro, AMP, Cheung, EYW, Chillotti, C, Choppin, S, Del Zompo, M, Dias, R, Dodd, S, Duffy, A, Etain, B, Fagiolini, A, Garnham, J, Geddes, J, Gildebro, J, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Kapur, V, Kunigiri, G, Lafer, B, Lam, C, Larsen, ER, Lewitzka, U, Licht, R, Lund, AH, Misiak, B, Piotrowski, P, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Scippa, AM, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Vieta, E, Vinberg, M, Viswanath, B, Volkert, J, Zetin, M, Zorrilla, I, Whybrow, PC, Bauer, M, Conell, J, Bauer, R, Glenn, T, Alda, M, Ardau, R, Baune, BT, Berk, M, Bersudsky, Y, Bilderbeck, A, Bocchetta, A, Bossini, L, Castro, AMP, Cheung, EYW, Chillotti, C, Choppin, S, Del Zompo, M, Dias, R, Dodd, S, Duffy, A, Etain, B, Fagiolini, A, Garnham, J, Geddes, J, Gildebro, J, Gonzalez-Pinto, A, Goodwin, GM, Grof, P, Harima, H, Hassel, S, Henry, C, Hidalgo-Mazzei, D, Kapur, V, Kunigiri, G, Lafer, B, Lam, C, Larsen, ER, Lewitzka, U, Licht, R, Lund, AH, Misiak, B, Piotrowski, P, Monteith, S, Munoz, R, Nakanotani, T, Nielsen, RE, O'Donovan, C, Okamura, Y, Osher, Y, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Sawchuk, B, Schwartz, E, Scippa, AM, Slaney, C, Sulaiman, AH, Suominen, K, Suwalska, A, Tam, P, Tatebayashi, Y, Tondo, L, Vieta, E, Vinberg, M, Viswanath, B, Volkert, J, Zetin, M, Zorrilla, I, Whybrow, PC, and Bauer, M

Abstract

BACKGROUND: Information seeking is an important coping mechanism for dealing with chronic illness. Despite a growing number of mental health websites, there is little understanding of how patients with bipolar disorder use the Internet to seek information. METHODS: A 39 question, paper-based, anonymous survey, translated into 12 languages, was completed by 1222 patients in 17 countries as a convenience sample between March 2014 and January 2016. All patients had a diagnosis of bipolar disorder from a psychiatrist. Data were analyzed using descriptive statistics and generalized estimating equations to account for correlated data. RESULTS: 976 (81 % of 1212 valid responses) of the patients used the Internet, and of these 750 (77 %) looked for information on bipolar disorder. When looking online for information, 89 % used a computer rather than a smartphone, and 79 % started with a general search engine. The primary reasons for searching were drug side effects (51 %), to learn anonymously (43 %), and for help coping (39 %). About 1/3 rated their search skills as expert, and 2/3 as basic or intermediate. 59 % preferred a website on mental illness and 33 % preferred Wikipedia. Only 20 % read or participated in online support groups. Most patients (62 %) searched a couple times a year. Online information seeking helped about 2/3 to cope (41 % of the entire sample). About 2/3 did not discuss Internet findings with their doctor. CONCLUSION: Online information seeking helps many patients to cope although alternative information sources remain important. Most patients do not discuss Internet findings with their doctor, and concern remains about the quality of online information especially related to prescription drugs. Patients may not rate search skills accurately, and may not understand limitations of online privacy. More patient education about online information searching is needed and physicians should recommend a few high quality websites.

Published
2016

37. Does lithium reduce acute suicidal ideation and behavior? A protocol for a randomized, placebo-controlled multicenter trial of lithium plus Treatment As Usual (TAU) in patients with suicidal major depressive episode

Author

Lewitzka, U., primary, Jabs, B., additional, Fülle, M., additional, Holthoff, V., additional, Juckel, G., additional, Uhl, I., additional, Kittel-Schneider, S., additional, Reif, A., additional, Reif-Leonhard, C., additional, Gruber, O., additional, Djawid, B., additional, Goodday, S., additional, Haussmann, R., additional, Pfennig, A., additional, Ritter, P., additional, Conell, J., additional, Severus, E., additional, and Bauer, M., additional

Published
2015
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39. Relationship between sunlight and the age of onset of bipolar disorder: An international multisite study

Author

Bauer, M, Glenn, T, Alda, M, Andreassen, OA, Angelopoulos, E, Ardau, R, Baethge, C, Bauer, R, Bellivier, F, Belmaker, RH, Berk, M, Bjella, TD, Bossini, L, Bersudsky, Y, Cheung, EYW, Conell, J, Del Zompo, M, Dodd, S, Etain, B, Fagiolini, A, Frye, MA, Fountoulakis, KN, Garneau-Fournier, J, Gonzalez-Pinto, A, Harima, H, Hassel, S, Henry, C, Iacovides, A, Isometsa, ET, Kapczinski, F, Kliwicki, S, Koenig, B, Krogh, R, Kunz, M, Lafer, B, Larsen, ER, Lewitzka, U, Lopez-Jaramillo, C, MacQueen, G, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Melle, I, Monteith, S, Morken, G, Munoz, R, Nery, FG, O'Donovan, C, Osher, Y, Pfennig, A, Quiroz, D, Ramesar, R, Rasgon, N, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Scippa, AM, Severus, E, Simhandl, C, Stein, DJ, Strejilevich, S, Sulaiman, AH, Suominen, K, Tagata, H, Tatebayashi, Y, Torrent, C, Vieta, E, Viswanath, B, Wanchoo, MJ, Zetin, M, Whybrow, PC, Bauer, M, Glenn, T, Alda, M, Andreassen, OA, Angelopoulos, E, Ardau, R, Baethge, C, Bauer, R, Bellivier, F, Belmaker, RH, Berk, M, Bjella, TD, Bossini, L, Bersudsky, Y, Cheung, EYW, Conell, J, Del Zompo, M, Dodd, S, Etain, B, Fagiolini, A, Frye, MA, Fountoulakis, KN, Garneau-Fournier, J, Gonzalez-Pinto, A, Harima, H, Hassel, S, Henry, C, Iacovides, A, Isometsa, ET, Kapczinski, F, Kliwicki, S, Koenig, B, Krogh, R, Kunz, M, Lafer, B, Larsen, ER, Lewitzka, U, Lopez-Jaramillo, C, MacQueen, G, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Melle, I, Monteith, S, Morken, G, Munoz, R, Nery, FG, O'Donovan, C, Osher, Y, Pfennig, A, Quiroz, D, Ramesar, R, Rasgon, N, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Scippa, AM, Severus, E, Simhandl, C, Stein, DJ, Strejilevich, S, Sulaiman, AH, Suominen, K, Tagata, H, Tatebayashi, Y, Torrent, C, Vieta, E, Viswanath, B, Wanchoo, MJ, Zetin, M, and Whybrow, PC

Abstract

BACKGROUND: The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode. METHODS: Data from 4037 patients with bipolar I disorder were collected at 36 collection sites in 23 countries at latitudes spanning 3.2 north (N) to 63.4 N and 38.2 south (S) of the equator. The age of onset of the first episode, onset location, family history of mood disorders, and polarity of first episode were obtained retrospectively, from patient records and/or direct interview. Solar insolation data were obtained for the onset locations. RESULTS: There was a large, significant inverse relationship between maximum monthly increase in solar insolation and age of onset, controlling for the country median age and the birth cohort. The effect was reduced by half if there was no family history. The maximum monthly increase in solar insolation occurred in springtime. The effect was one-third smaller for initial episodes of mania than depression. The largest maximum monthly increase in solar insolation occurred in northern latitudes such as Oslo, Norway, and warm and dry areas such as Los Angeles, California. LIMITATIONS: Recall bias for onset and family history data. CONCLUSIONS: A large springtime increase in sunlight may have an important influence on the onset of bipolar disorder, especially in those with a family history of mood disorders.

Published
2014

41. Antidepressant dosage taken by patients with bipolar disorder: factors associated with irregularity

Author

Bauer, R, Glenn, T, Alda, M, Sagduyu, K, Marsh, W, Grof, P, Munoz, R, Murray, G, Ritter, P, Lewitzka, U, Severus, E, Whybrow, PC, Bauer, M, Bauer, R, Glenn, T, Alda, M, Sagduyu, K, Marsh, W, Grof, P, Munoz, R, Murray, G, Ritter, P, Lewitzka, U, Severus, E, Whybrow, PC, and Bauer, M

Abstract

BACKGROUND: This study analyzed regularity in the daily dosage of antidepressants taken by patients with bipolar disorder and identified the factors associated with irregularity. METHODS: Daily self-reported medication dosage taken and mood ratings were available from 144 patients who received treatment as usual. All 144 patients took the same antidepressant for at least 100 days. One hundred eleven of these patients were also taking a mood stabilizer. Approximate entropy (ApEn) was used to measure serial regularity in daily dosage. Regularity is the tendency that values within a time series remain the same on incremental comparisons. Drug holidays (missing three or more consecutive days) were also determined. Generalized estimating equations (GEE) were used to estimate if any demographic or clinical variables were associated with regularity. RESULTS: Although the mean percent of days missing doses was only 18.6%, there was a wide range of regularity in the daily antidepressant dosage. Drug holidays were common, occurring in 41% of the analyses. Factors significantly associated with irregularity were as follows: total number of psychotropic medications (p = 0.005), pill burden (p = 0.005), and depression (p = 0.015). Neither the percent of days missing doses nor the drug holidays were associated with any demographic or clinical factors. For patients taking both antidepressants and mood stabilizers, there was no significant difference in regularity in daily dosage between these drugs. DISCUSSION: There can be considerable irregularity in daily dosage despite a low percent of days missing doses. Medication regimen complexity and depressed mood are associated with increased irregularity. Daily regularity in drug dosage may be more dependent on the individual than on the specific drug. Research on the clinical impact of irregularity in daily dosage of antidepressants is needed.

Published
2013

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