Pub Date : 2024-05-01DOI: 10.1136/gpsych-2023-101370
Clíodhna O’Connor
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Pub Date : 2024-05-01DOI: 10.1136/gpsych-2023-101239
B. Lei, Hongliang Feng, Lulu Yang, Jing Wang, Jie Chen, Weidong Song, Chao Jiang, Kun Zhang, Qunfeng Wang, Jessie Chi Ching Tsang, N. Chan, Yaping Liu, Joey W.Y. Chan, Jiyang Pan, Bin Zhang, Tao Li, K. Merikangas, Jihui Zhang, Y. Wing
Background Understanding the evolution of circadian rhythm dysfunction and psychopathology in the high-risk population has important implications for the prevention of bipolar disorder. Nevertheless, some of the previous studies on the emergence of psychopathologies and circadian dysfunction among high-risk populations were inconsistent and limited. Aims To examine the prevalence rates of sleep and circadian dysfunctions, mental disorders and their symptoms in the offspring of parents with (O-BD) and without bipolar disorder (O-control). Methods The study included 191 O-BD and 202 O-control subjects aged 6–21 years from the Greater Bay Area, China. The diagnoses and symptoms of sleep/circadian rhythm and mental disorders were assessed by the Diagnostic Interview for Sleep Patterns and Disorders, and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, respectively. Generalised estimating equations and shared frailty proportional hazards models of survival analysis were applied to compare the outcomes in the offspring. Results Adjusting for age, sex and region of recruitment, there was a significantly higher risk of delayed sleep phase symptoms (9.55% vs 2.58%, adjusted OR: 4.04) in O-BD than in O-control. O-BD had a nearly fivefold higher risk of mood disorders (11.70% vs 3.47%, adjusted OR: 4.68) and social anxiety (6.28% vs 1.49%, adjusted OR: 4.70), a fourfold higher risk of depressive disorders (11.17% vs 3.47%, adjusted OR: 3.99) and a threefold higher risk of mood symptoms (20.74% vs 10.40%, adjusted OR: 2.59) than O-control. Subgroup analysis revealed that O-BD children (aged under 12 years) had a nearly 2-fold higher risk of any mental and behavioural symptoms than O-control, while there was a nearly 4-fold higher risk of delayed sleep phase symptoms, a 7.5-fold higher risk of social anxiety and a 3-fold higher risk of mood symptoms in O-BD adolescents (aged 12 years and over). Conclusions There was an increase in delayed sleep phase symptoms in O-BD adolescents compared with their control counterparts, confirming the central role of circadian rhythm dysfunction in bipolar disorder. The findings of the specific age-related and stage-related developmental patterns of psychopathologies and circadian dysfunction in children and adolescent offspring of parents with bipolar disorder paved the way to develop specific and early clinical intervention and prevention strategies. Trial registration number NCT03656302.
背景 了解高危人群中昼夜节律失调和精神病理学的演变对预防躁郁症有重要意义。然而，以往关于高危人群中出现精神病态和昼夜节律失调的研究并不一致，且研究内容有限。目的 研究患有躁郁症（O-BD）和未患有躁郁症（O-control）的父母的后代中睡眠和昼夜节律功能障碍、精神障碍及其症状的患病率。方法 研究对象包括来自中国粤港澳大湾区的 191 名 O-BD 受试者和 202 名 O-control 受试者，年龄在 6-21 岁之间。睡眠/昼夜节律和精神障碍的诊断和症状分别通过睡眠模式和障碍诊断访谈以及学龄儿童情感障碍和精神分裂症时间表--现在版和终生版进行评估。应用广义估计方程和共享虚弱比例危险生存分析模型对后代的结果进行比较。结果 在对年龄、性别和招募地区进行调整后，O-BD 患睡眠期延迟症状的风险（9.55% vs 2.58%，调整后 OR：4.04）明显高于 O-对照组。与 O-对照组相比，O-BD 患情绪障碍（11.70% vs 3.47%，调整 OR：4.68）和社交焦虑（6.28% vs 1.49%，调整 OR：4.70）的风险高出近 5 倍，患抑郁障碍（11.17% vs 3.47%，调整 OR：3.99）的风险高出 4 倍，患情绪症状（20.74% vs 10.40%，调整 OR：2.59）的风险高出 3 倍。分组分析显示，O型糖尿病儿童（12岁以下）出现任何精神和行为症状的风险比O型对照组高出近2倍，而O型糖尿病青少年（12岁及以上）出现睡眠时相延迟症状的风险高出近4倍，出现社交焦虑的风险高出7.5倍，出现情绪症状的风险高出3倍。结论 与对照组青少年相比，O型躁狂症青少年的睡眠延迟症状有所增加，这证实了昼夜节律功能紊乱在躁狂症中的核心作用。双相情感障碍儿童和青少年后代的精神病理学和昼夜节律失调的特定年龄相关和阶段相关发展模式的发现，为制定特定的早期临床干预和预防策略铺平了道路。试验注册号：NCT03656302。
{"title":"Circadian rhythm dysfunction and psychopathology in the offspring of parents with bipolar disorder: a high-risk study in the Chinese population","authors":"B. Lei, Hongliang Feng, Lulu Yang, Jing Wang, Jie Chen, Weidong Song, Chao Jiang, Kun Zhang, Qunfeng Wang, Jessie Chi Ching Tsang, N. Chan, Yaping Liu, Joey W.Y. Chan, Jiyang Pan, Bin Zhang, Tao Li, K. Merikangas, Jihui Zhang, Y. Wing","doi":"10.1136/gpsych-2023-101239","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101239","url":null,"abstract":"Background Understanding the evolution of circadian rhythm dysfunction and psychopathology in the high-risk population has important implications for the prevention of bipolar disorder. Nevertheless, some of the previous studies on the emergence of psychopathologies and circadian dysfunction among high-risk populations were inconsistent and limited. Aims To examine the prevalence rates of sleep and circadian dysfunctions, mental disorders and their symptoms in the offspring of parents with (O-BD) and without bipolar disorder (O-control). Methods The study included 191 O-BD and 202 O-control subjects aged 6–21 years from the Greater Bay Area, China. The diagnoses and symptoms of sleep/circadian rhythm and mental disorders were assessed by the Diagnostic Interview for Sleep Patterns and Disorders, and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, respectively. Generalised estimating equations and shared frailty proportional hazards models of survival analysis were applied to compare the outcomes in the offspring. Results Adjusting for age, sex and region of recruitment, there was a significantly higher risk of delayed sleep phase symptoms (9.55% vs 2.58%, adjusted OR: 4.04) in O-BD than in O-control. O-BD had a nearly fivefold higher risk of mood disorders (11.70% vs 3.47%, adjusted OR: 4.68) and social anxiety (6.28% vs 1.49%, adjusted OR: 4.70), a fourfold higher risk of depressive disorders (11.17% vs 3.47%, adjusted OR: 3.99) and a threefold higher risk of mood symptoms (20.74% vs 10.40%, adjusted OR: 2.59) than O-control. Subgroup analysis revealed that O-BD children (aged under 12 years) had a nearly 2-fold higher risk of any mental and behavioural symptoms than O-control, while there was a nearly 4-fold higher risk of delayed sleep phase symptoms, a 7.5-fold higher risk of social anxiety and a 3-fold higher risk of mood symptoms in O-BD adolescents (aged 12 years and over). Conclusions There was an increase in delayed sleep phase symptoms in O-BD adolescents compared with their control counterparts, confirming the central role of circadian rhythm dysfunction in bipolar disorder. The findings of the specific age-related and stage-related developmental patterns of psychopathologies and circadian dysfunction in children and adolescent offspring of parents with bipolar disorder paved the way to develop specific and early clinical intervention and prevention strategies. Trial registration number NCT03656302.","PeriodicalId":504531,"journal":{"name":"General Psychiatry","volume":"340 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141144016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1136/gpsych-2023-101456
Jiahao Min, Zhi Cao, Han Chen, Xiaohe Wang, Chenjie Xu
Depressive symptoms are established risk factors for various health outcomes. However, previous studies assessed depressive symptoms at a single time point, neglecting individual variations over time.To identify depressive symptoms trajectories through repeated measures and examine their associations with cardiovascular disease (CVD), cancer and mortality.This study included 20 634 UK Biobank participants free of CVD and cancer at baseline with two or more assessments of depressive symptoms during 2006–2016. Group-based trajectory modelling identified depressive symptoms trajectories. Incident CVD, cancer and mortality were followed up until 2021 through linked registries.Six depressive symptoms trajectories were identified: no symptoms (n=6407), mild-stable (n=11 539), moderate-stable (n=2183), severe-decreasing (n=206), moderate-increasing (n=177) and severe-stable (n=122). During a median follow-up of 5.5 years, 1471 CVD cases, 1275 cancer cases and 503 deaths were documented. Compared with the no symptoms trajectory, the mild-stable, moderate-stable and severe-stable trajectories exhibited higher CVD risk, with hazard ratios (HRs) (95% CIs) of 1.19 (1.06 to 1.34), 1.32 (1.08 to 1.34) and 2.99 (1.85 to 4.84), respectively. Moderate-increasing and severe-stable trajectories were associated with higher mortality risks, with HRs (95% CIs) of 2.27 (1.04 to 4.93) and 3.26 (1.55 to 6.88), respectively. However, the severe-decreasing trajectory was not associated with higher risks of adverse outcomes. We did not find significant associations between any trajectory and cancer.Trajectories related to stable and increasing depressive symptoms, but not the trajectory associated with severe depressive symptoms at the initial assessment but decreasing at the follow-up, were associated with higher risks of CVD and mortality. Alleviating severe depressive symptoms at the initial onset may mitigate CVD and mortality risks.
{"title":"Trajectories of depressive symptoms and risk of cardiovascular disease, cancer and mortality: a prospective cohort study","authors":"Jiahao Min, Zhi Cao, Han Chen, Xiaohe Wang, Chenjie Xu","doi":"10.1136/gpsych-2023-101456","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101456","url":null,"abstract":"Depressive symptoms are established risk factors for various health outcomes. However, previous studies assessed depressive symptoms at a single time point, neglecting individual variations over time.To identify depressive symptoms trajectories through repeated measures and examine their associations with cardiovascular disease (CVD), cancer and mortality.This study included 20 634 UK Biobank participants free of CVD and cancer at baseline with two or more assessments of depressive symptoms during 2006–2016. Group-based trajectory modelling identified depressive symptoms trajectories. Incident CVD, cancer and mortality were followed up until 2021 through linked registries.Six depressive symptoms trajectories were identified: no symptoms (n=6407), mild-stable (n=11 539), moderate-stable (n=2183), severe-decreasing (n=206), moderate-increasing (n=177) and severe-stable (n=122). During a median follow-up of 5.5 years, 1471 CVD cases, 1275 cancer cases and 503 deaths were documented. Compared with the no symptoms trajectory, the mild-stable, moderate-stable and severe-stable trajectories exhibited higher CVD risk, with hazard ratios (HRs) (95% CIs) of 1.19 (1.06 to 1.34), 1.32 (1.08 to 1.34) and 2.99 (1.85 to 4.84), respectively. Moderate-increasing and severe-stable trajectories were associated with higher mortality risks, with HRs (95% CIs) of 2.27 (1.04 to 4.93) and 3.26 (1.55 to 6.88), respectively. However, the severe-decreasing trajectory was not associated with higher risks of adverse outcomes. We did not find significant associations between any trajectory and cancer.Trajectories related to stable and increasing depressive symptoms, but not the trajectory associated with severe depressive symptoms at the initial assessment but decreasing at the follow-up, were associated with higher risks of CVD and mortality. Alleviating severe depressive symptoms at the initial onset may mitigate CVD and mortality risks.","PeriodicalId":504531,"journal":{"name":"General Psychiatry","volume":"33 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.1136/gpsych-2023-101409
Robert Wichers, Hanna M Heller, Sisco van Veen
{"title":"Deciding on life-saving treatment after a violent suicide attempt: an ethical case report","authors":"Robert Wichers, Hanna M Heller, Sisco van Veen","doi":"10.1136/gpsych-2023-101409","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101409","url":null,"abstract":"","PeriodicalId":504531,"journal":{"name":"General Psychiatry","volume":"42 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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