Detection of bipolar disorder in the prodromal phase: A systematic review of assessment instruments.

BACKGROUND: Early detection of prodromal symptoms may contribute to improving the prognosis of patients with bipolar disorder (BD). The main objective of this systematic review is to present the different procedures for the identification of initial and relapse prodromes in these patients. METHODS: PsycINFO, Web of Science and PubMed databases were searched using a predetermined strategy, until January 4, 2022. Then, by means of a regulated process, studies that used a BD prodrome detection procedure, in English-language and all ages participants were selected. Quantitative and qualitative studies were assessed using a modified version of the Newcastle-Ottawa Scale and by Critical Appraisals Skills Programme checklist, respectively. RESULTS: Forty-five studies were selected. Of these, 26 used procedures for identifying initial prodromes (n = 8014) and 19 used procedures for detecting relapse prodromes (n = 1136). The interview was the most used method in the detection of both types of prodromes (k = 30 papers, n = 4068). It was variable in its degree of structure. Mobile applications and digital technologies are gaining importance in the detection of the relapse prodromes. LIMITATIONS: A retrospective design in most papers, small samples sizes, existence of persistent subsyndromal symptoms and difficulty to identify the end of the prodrome and the onset of the disorder. CONCLUSIONS: There is a wide variety of assessment instruments to detect prodromes in BD, among which the clinical interview is most frequently used. Future research should consider development of a brief tool to be applied in different formats to patients and family members.

Interleukin 6 and depression in patients affected by Covid-19.

INTRODUCTION: Rise of central cytokines resulting from infections produces neuronal changes. Covid-19 allows the study of depressive symptoms in sustained stress and its relationship with molecular mechanisms. OBJECTIVES: To assess correlation between IL-6, IL-1ß and TNF-α and depressive symptoms. Characterize the depressive symptoms present. METHODS: Observational study. Patients admitted for Covid-19 older than 60 years with a interleukin determination were included. The Yesavage Geriatric Depression Scale was used, associating each item with a neurotransmitter. RESULTS: 27 patients included. We did not find correlation between IL-6 levels and the GDS scale score (rho = 0.204; 95% CI -0.192 to 0.543); with IL-1ß levels (rho = -0.126; 95% CI -0.490 to 0.276); nor of TNF-α (rho = -0.033; 95% CI -0.416 to 0.360). 3 patients (11.1%) presented score compatible with depressive disorder. It was associated with a deficiency of Noradrenaline and Serotonin. CONCLUSIONS: We found no correlation between the levels of IL-6, IL-1ß, and TNF-α with the GDS score. Depressive symptomatology is similar to vascular depressions.

INTRODUCCIÓN: El incremento de citocinas centrales resultante de infecciones produce cambios neuronales. La Covid-19 permite estudiar los síntomas depresivos en un estrés sostenido y su relación con mecanismos moleculares. OBJETIVOS: Valorar la correlación entre niveles de IL-6, IL-1ß y TNF-α y sintomatología depresiva. Caracterizar los cuadros depresivos presentes. MÉTODOS: Estudio observacional. Se incluyeron pacientes ingresados por Covid-19 mayores de 60 años con una determinación de interleucinas. Se utilizó la Escala de depresión geriátrica de Yesavage, asociándose cada ítem con un neurotransmisor. RESULTADOS: 27 pacientes incluidos. No encontramos correlación entre los niveles de IL-6 y la puntuación de la escala GDS (rho = 0,204; IC95% −0.192 a 0.543); con los niveles de IL-1ß (rho = −0,126; IC95% −0.490 a 0.276); ni de TNF-α (rho = −0,033; IC95% −0.416 a 0.360). 3 pacientes (11,1%) presentaron una puntuación compatible con cuadro depresivo. Se asoció a déficit de Noradrenalina y Serotonina. CONCLUSIONES: No hallamos correlación entre los niveles de IL-6, IL-1ß y TNF-α con la puntuación en la GDS. La sintomatología depresiva presenta características similares a las depresiones vasculares.

[Interleukin 6 and depression in patients affected by Covid-19]. / Relación entre los niveles de interleucina 6 y depresión en pacientes afectados por Covid-19.

INTRODUCTION: Rise of central cytokines resulting from infections produces neuronal changes. Covid-19 allows the study of depressive symptoms in sustained stress and its relationship with molecular mechanisms. OBJECTIVES: To assess correlation between IL-6, IL-1ß and TNF-α and depressive symptoms. Characterize the depressive symptoms present. METHODS: Observational study. Patients admitted for Covid-19 older than 60 years with a interleukin determination were included. The Yesavage Geriatric Depression Scale (GDS) was used, associating each item with a neurotransmitter. RESULTS: 27 patients included. We did not find correlation between IL-6 levels and the GDS scale score (rho=0.204; 95% CI -0.192 to 0.543); with IL-1ß levels (rho=-0.126; 95% CI -0.490 to 0.276); nor of TNF-α (rho=-0.033; 95% CI -0.416 to 0.360). 3 patients (11.1%) presented score compatible with depressive disorder. It was associated with a deficiency of noradrenaline and serotonin. CONCLUSIONS: We found no correlation between the levels of IL-6, IL-1ß, and TNF-α with the GDS score. Depressive symptomatology is similar to vascular depressions.