Serum biomarkers, lifetime substance use and conversion to bipolar disorder.

IF 1.2 4区医学 Q4 NEUROSCIENCES

Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique Pub Date : 2024-11-06 DOI:10.1016/j.encep.2024.06.008

Natália Wirowski, Andressa Schneider Lobato, Letícia Vasques Bender, Taiane de Azevedo Cardoso, Thaise Campos Mondin, Luciano Dias de Mattos Souza, Ricardo Azevedo da Silva, Jean Pierre Oses, Carolina David Wiener, Karen Jansen, Fernanda Pedrotti Moreira

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引用次数: 0

Abstract

Introduction: The diagnostic conversion of major depressive disorder (MDD) to bipolar disorder (BD) is a topic that is currently the subject of several studies. However, there are few studies that clarify the interaction between conversion, substance use and biomarkers.

Objectives: The aim of this study was to investigate serum biomarker levels and lifetime substance use as predictors for diagnostic conversion from major depressive disorder to bipolar disorder in an outpatient sample of adults.

Methods: This was a prospective longitudinal study nested within a larger two-phase study. Male and female individuals, between the ages of 18 and 60, diagnosed with MDD by the Mini International Neuropsychiatric Interview Plus who participated in the two stages of the study were included. The instrument alcohol smoking and substance involvement screening test (ASSIST) was used to evaluate substance use. The enzyme linked immuno sorbent assay (ELISA) technique was used to measure the levels of the following biomarkers: brain derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial cell line-derived neurotrophic factor (GDNF), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α).

Results: The conversion rate from MDD to BD was 12.4%. The prevalence of female individuals, subjects with up to eight years of schooling, who had lifetime psychotic symptoms and reported lifetime use of cocaine was higher among individuals who converted their diagnosis to BD than among individuals who did not (P<0.05). In the crude analysis, there was no interaction between biomarkers and substance use except for NGF with cocaine. Based on the adjusted analysis model, it was observed that the interaction remains (OR: 1.476; 95% CI: 1.019-2.137).

Conclusions: Individuals with late diagnosis and treatment of bipolar disorder may have a worse prognosis. Therefore, results suggesting that NGF and cocaine use are potential predictors of conversion to bipolar disorder can help in clinical practice, contributing to the identification of conversion and to more specific therapeutic interventions.

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血清生物标志物、终生使用药物和转化为躁郁症。

导言：重度抑郁障碍（MDD）向双相情感障碍（BD）的诊断转换是目前多项研究的主题。然而，很少有研究能阐明转换、药物使用和生物标志物之间的相互作用：本研究旨在调查门诊成人样本中血清生物标志物水平和终生药物使用情况，以预测重度抑郁障碍向双相情感障碍的诊断转换：这是一项前瞻性纵向研究，嵌套在一项规模更大的两阶段研究中。研究对象包括年龄在 18 岁至 60 岁之间、通过迷你国际神经精神病学访谈强化版确诊为重度抑郁症并参与了两个阶段研究的男性和女性。评估药物使用情况的工具是酒精吸烟和药物参与筛查测试（ASSIST）。采用酶联免疫吸附试验（ELISA）技术测量以下生物标志物的水平：脑源性神经营养因子（BDNF）、神经生长因子（NGF）、胶质细胞系源性神经营养因子（GDNF）、白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）：从 MDD 到 BD 的转化率为 12.4%。女性患者、受教育年限不超过 8 年的受试者、终生有精神病症状的受试者以及报告终生使用可卡因的受试者中，诊断为 BD 的受试者的患病率高于未诊断为 BD 的受试者：双相情感障碍诊断和治疗较晚的患者预后可能较差。因此，研究结果表明，NGF和可卡因的使用是转化为双相情感障碍的潜在预测因素，这有助于临床实践，有助于识别双相情感障碍的转化并采取更有针对性的治疗干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique 医学-精神病学

CiteScore

4.60

自引率

7.40%

发文量

162

审稿时长

6-12 weeks

期刊介绍： Une revue française de renommée internationale. - Un comite de rédaction représentant tous les aspects de la prise en charge psychiatrique du patient. - Une sélection rigoureuse d''articles faisant l''objet de plusieurs expertises. - Des travaux d''auteurs et de chercheurs de renommée internationale. - Des indexations dans les grandes bases de données (Current Contents, Excerpta Medica, etc.). - Un facteur d''impact qui témoigne de la grande notoriété de la revue. La tribune des publications originales de haut niveau. - Une très grande diversité des sujets traités, rigoureusement sélectionnés à travers des sommaires dynamiques : - des éditoriaux de médecins référents, - une revue de presse sur les actualités internationales, - des articles originaux pour approfondir vos connaissances, - des mises au point et des cas cliniques pour engager votre réflexion sur les indications et choix possibles au travers de mises en situation clinique, - des dossiers thématiques pour faire le tour d''une question. - L''actualité de l''AFPB : L''Encéphale publie régulièrement des comptes rendus de l''Association française de psychiatrie clinique.