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BACKGROUND: Affective disorders (AD) have been linked to inflammatory processes, although the underlying mechanisms of this relationship are still not fully elucidated. It is hypothesized that demographic, somatic, lifestyle, and personality variables predict inflammatory parameters in AD. AIM: To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters, C-reactive protein (CRP) and leukocytes. METHODS: This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters, serum inflammatory markers, somatic variables, psychological questionnaires, and lifestyle parameters. Hierarchical regression analyses were used to predict inflammatory markers from demographic, somatic, lifestyle, and personality variables. RESULTS: Analyses showed that 33.8% of the variance of CRP was explained by body mass index and other somatic medication (e.g. anti-diabetics), age and education, and age of affective disorder diagnosis. For leukocytes, 20.1% of the variance was explained by smoking, diet, metabolic syndrome (MetS), and anti-inflammatory medication (e.g. non-steroidal anti-inflammatory drugs). Other psychiatric or behavioural variables did not reach significance. CONCLUSION: Metabolic components seem important, with mounting evidence for a metabolic affective disorder subtype. Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.
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Background: Research on depression showed that dysregulations in tryptophan (TRP), kynurenine (KYN), and its KYN pathway metabolites are key aspects in the development and maintenance of depressive symptoms. In our previous reports, we described sex-specific changes in TRP breakdown as well as changes in KYN and KYN/TRP in association with treatment response and inflammatory and metabolic parameters. However, results of treatment effects on KYN pathway metabolites as well as how pathway changes are related to treatment response remain sparse. Objective: We investigated potential changes of KYN and KYN pathway metabolites in association with therapeutic response of individuals with depression during a six-week multimodal psychiatric rehabilitation program. Methods: 87 participants were divided into treatment responders and non-responders (48 responders, 39 non-responders; 38 male, 49 female; M age = 51.09; SD age = 7.70) using scores of psychological questionnaires. KYN pathway metabolites serum concentrations as well as their ratios were collected using high performance liquid chromatography. Changes over time (time of admission (t1) vs. time of discharge (t2)) were calculated using repeated measure analyses of (co)variance. Results: Non-responders exhibited higher levels of 3-Hydroxyanthralinic acid (3-HAA), nicotinic acid (NA), and 3-HAA/KYN, independently of measurement time. NA levels decreased, while 3-HAA levels increased over time in both groups, independently of treatment response. 3-HK/KYN levels decreased, while KYN levels increased in non-responders, but not in responders over time. Discussion: The results indicate that some compounds of the KYN pathway metabolites can be altered through multimodal long-term interventions in association with treatment response. Especially the pathway degrading KYN further down to 3-HAA and 3-HK/KYN might be decisive for treatment response in depression.
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Theory of mind (ToM) deficits, difficulties in recognizing the intentions, propensities, and beliefs of others have been shown in individuals with bipolar disorder in several studies; however, it is not yet elucidated how ToM abilities changes over the course of bipolar disorder and is related to illness symptoms. This is one of the first longitudinal studies to compare the ToM abilities of euthymic bipolar individuals and healthy controls over a four and a half years period. ToM abilities were measured using the Reading the Mind in the Eyes Test (RMET). A total of 91 euthymic bipolar individuals and 91 healthy controls were included in the analyses. Linear mixed models were used to compare ToM abilities of bipolar individuals and healthy controls. It was found that bipolar individuals scored lower on average on the RMET than healthy controls and that these RMET scores were stable over four and a half years. The results of this study suggest that ToM deficits are a stable (possibly endophenotypic) trait of bipolar disorder. This understanding can contribute to better identification, assessment, and treatment strategies for individuals with bipolar disorder, ultimately improving their overall care and outcome.
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Transtorno Bipolar , Teoria da Mente , Humanos , Transtorno Bipolar/psicologia , Transtorno Bipolar/fisiopatologia , Teoria da Mente/fisiologia , Feminino , Masculino , Estudos Longitudinais , Adulto , Pessoa de Meia-Idade , Testes NeuropsicológicosRESUMO
INTRODUCTION: C-reactive protein (CRP) is a systemic inflammatory marker, which indicates systemic inflammatory processes It is involved in different inflammatory processes of the body and is a reliable marker for the general inflammatory state of the body. High sensitive CRP seems to play a key role as a state and trait marker of bipolar disorder (BD). In the current study, we tried to determine the long-term effect of CRP levels on clinical symptoms and illness course of bipolar disorder. METHODS: For the current study, we examined 106 patients with BD for a period of four years. Participants underwent a clinical screening for depressive and manic episodes with the Hamilton Depression Scale (HAMD) and the Young Mania Rating Score (YMRS) and a serological diagnostic for inflammatory parameters every six months, thus leading to 8 measurement times in total. Patients with the presence of severe medical or neurological comorbidities such as active cancer, chronic obstructive lung disease, rheumatoid arthritis, systemic lupus erythematosus, Alzheimer's disease, Parkinson's disease, Huntington's disease or multiple sclerosis and acute infections were not included in the study. RESULTS: In our sample, 26% showed a mean hsCRP above 5 mg/dl. Those patients showed a significantly higher mean YMRS score than those with a mean hsCRP under 5 mg/dl during our observation period. Regarding HAMD there was no significant difference in hsCRP values. The existence of lithium treatment showed no significant influence on mean hsCRP levels between the start and endpoint. CONCLUSION: Individuals who were exposed to a higher level of inflammation over time suffered from more manic symptoms in this period. These findings underline the hypothesis that inflammatory processes have an accumulative influence on the illness course of BD, especially concerning manic symptoms and episodes.
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Transtorno Bipolar , Proteína C-Reativa , Inflamação , Humanos , Transtorno Bipolar/sangue , Feminino , Masculino , Adulto , Inflamação/sangue , Estudos Longitudinais , Proteína C-Reativa/metabolismo , Pessoa de Meia-Idade , Doença Crônica , Progressão da Doença , Escalas de Graduação Psiquiátrica , Biomarcadores/sangueRESUMO
Introduction: Deteriorated sleep quality is a predisposing factor and symptom of affective disorders (AD). It is important to investigate factors driving the relationship between sleep and AD, such as personality traits. Previous research has shown that personality traits such as the Dark Triad personality traits (DT) narcissism, Machiavellianism, and psychopathy are associated with sleep problems and AD. The current study examined the moderating influence of the DT in the relationship between AD [versus healthy controls (HC)] and sleep quality. Methods: Data of 657 individuals (267 HC, 390 AD; 483 female, 166 male, eight diverse; Mage = 34.87, SDage = 13.86) were collected in an online survey, which administered the Pittsburgh Sleep Quality Index and the Short Dark Triad questionnaire. Results: Moderation analyses controlling for age and gender revealed that Machiavellianism (b = -0.76, p < 0.05, R2 = 0.35) and psychopathy (b = -1.15, p < 0.05, R2 = 0.35), but not narcissism (b = -0.20, p = 0.620, R2 = 0.35), had a negative effect on sleep quality. Specifically, this effect is more pronounced in the HC group, but sleep quality is generally worse in AD. Conclusion: Our findings indicate that Machiavellianism and psychopathy should be considered in the prevention and treatment of AD-associated sleep problems. Particularly, monitoring these traits could help to implement timely measures for the prevention of sleep problems, such as psychoeducation and sleep hygiene. The results highlight the role of personality in the aetiopathogenesis of AD and require further differentiation to examine the underlying pathways between the DT, sleep, and AD.
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Recent evidence on the association between vitamin D and cognition in mentally healthy individuals is inconsistent. Furthermore, the link between vitamin D and cognitive ability in individuals with bipolar disorder has not been studied yet. Thus, we aimed to investigate the association between 25-hydroxyvitamin D (25(OH)D), 24,25 dihydroxyvitamin D (24,25(OH)2D, the vitamin D metabolite ratio (VMR) and cognition in a cohort of euthymic patients with bipolar disorder. Vitamin D metabolites were measured simultaneously by liquid-chromatography tandem mass-spectrometry in serum samples from 86 outpatients with bipolar disorder and 93 healthy controls. Neither the inactive precursor 25(OH)D, nor the primary vitamin D catabolite 24,25(OH)2D, or the vitamin D metabolite ratio were significantly associated with the domains "attention", "memory", or "executive function" in individuals with bipolar disorder and healthy controls. Further, no vitamin D deficiency effect or interaction group × vitamin D deficiency was found in the cognitive domain scores. In summary, the present study does not support vitamin D metabolism as a modulating factor of cognitive function in euthymic BD patients. Considering the current study's cross-sectional design, future research should expand these results in a longitudinal setting and include additional aspects of mental health, such as manic or depressive symptoms, long-term illness course and psychopharmacological treatment.
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Transtorno Bipolar , Deficiência de Vitamina D , Humanos , Transtorno Bipolar/complicações , Transtorno Bipolar/psicologia , Estudos Transversais , Vitamina D , Cognição , VitaminasRESUMO
Previous research has focused on the relationship between affective disorders (AD) and metabolic syndrome (MetS). Aside from biological and lifestyle factors, personality traits were identified as influencing aspects. In particular, the Dark Triad personality traits (DT; Machiavellianism, narcissism, psychopathy) were connected to both AD and worse somatic health, thus possibly resulting in MetS. This observational study aimed to investigate the associations between DT and anthropometric parameters and differences in the DT traits concerning the presence of MetS in individuals with AD. A total of 112 individuals (females = 59, males = 51, diverse = 2, Mage = 47.5, SDage = 11.5) with AD filled out the Short Dark Triad questionnaire. Body Mass Index (BMI) and MetS criteria, including blood pressure, waist circumference, lipid, and glucose levels, were assessed. For Machiavellianism, a positive association with BMI (r = 0.29, p < 0.05) and a negative association with systolic blood pressure (r = -0.23, p < 0.05) were found. No relationship between the overall MetS and DT score (r = 0.08, p = 0.409) was observed. The results were limited by the lack of a control group and the cross-sectional study design, which does not allow for the determination of causality. Machiavellianism was associated with a higher BMI and lower systolic blood pressure, indicating a deteriorating health effect of this trait. Possibly, the higher prevalence of MetS in AD stems from aspects such as lifestyle or medication intake, which might also be influenced by DT. Further research is needed to disentangle underlying mechanisms.
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BACKGROUND: Due to the COVID-19 pandemic, workplaces in the medical field experienced changes. Non-frontline workers in the health sector (WHS) were in many cases allowed to work from home (WFH). Changes in work locations have affected the perception of productivity during the COVID-19 pandemic compared to the pre-pandemic perception. Studies regarding this research field are rare for WHS. The aim of the present study was to investigate the perception of productivity and its impact on symptoms of depression during the COVID-19 pandemic. The second objective was to assess the implications for post-pandemic work settings such as WFH or work scenarios in hospitals during pandemics. METHODS: At three points in time during the COVID-19 pandemic (t1; n = 161: April 2020, t2; n = 1598 winter 2020/2021, t3; n = 1879 winter 2021/2022), an online survey of WHS (e.g., medical doctors, nurses, scientific staff) in Austria concerning their productivity in their current workplace (pre- and post-pandemic) was conducted. The online survey included questions about the perceptions of productivity changes (i.e., perceptions of lower, equal, and higher productivity, before and during the COVID-19 pandemic) in different work settings (e.g., working in a hospital or working from home), as well as standardized questionnaires like the Patient Health Questionnaire (PHQ-9), assessing symptoms of depression in WHS. RESULTS: χ2 tests showed that WHS working in hospitals experienced significantly fewer fluctuations in their perceptions of productivity than WHS working from home. An analysis of variance (ANOVA) indicated that WHS with a lower perception of productivity tended to have higher self-assessed depressive symptoms. CONCLUSION: The possibility of remaining working in the hospital in stressful scenarios like the COVID-19 pandemic might stabilize the feeling of productivity. Moreover, productivity is associated with self-assessed depressive symptoms. Hence, looking into the reasons behind this discrepancy between WHS in hospitals and those working from home might help to improve the home office modality and to create better structures, which are related to symptoms of depression.
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Background: Psychopathic personality traits (PPT) and depression have both been shown to worsen emotional and cognitive functions. Moreover, PPT and depression share similar underlying neuronal circuits tapping into the emotional and cognitive domains. However, little is known about the influence of PPT on emotion and cognition in individuals with depression. Objectives: This study aimed to examine the correlative relationships and moderating role of PPT in the association between emotional competence and cognitive functions in individuals with depression. Methods: Data from 373 individuals diagnosed with depression (158 males, 215 females) were examined within a cohort study. Subjects filled out validated questionnaires surveying PPT and emotional competences. Furthermore, a comprehensive neuropsychological test battery was administered. Results: Correlation analyses revealed a significant positive association between emotional competence and cognitive functions. Further, negative associations between emotional competence and the PPT "Blame Externalisation" and "Careless Nonplanfulness," as well as positive associations with psychopathic "Social Potency" and "Stress Immunity" were found. Moderation analyses indicated a significant positive influence of psychopathic "Stress Immunity" and "Social Influence" on the relationship between emotional competence and cognitive functions. Conclusion: The findings highlight the importance of integrating PPT in depression research. Considering PPT in depression treatment could also facilitate the therapeutic process by identifying individual traits as resilience-strengthening or potentially harmful factors for depressive symptomatology. This study represents a stepping stone for further research regarding the role of personality traits in psychiatric disorders and their treatment.
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The global spread of the coronavirus disease (COVID-19) has created new challenges for the entire healthcare system, and those who work directly with the patients or even on the front lines with COVID-19 patients have been particularly stressed. Only a few studies are currently available investigating psychosomatic symptoms among healthcare workers, particularly frontline workers, over the entire pandemic period (2020-2022). There is also a lack of knowledge about strategies to prevent stress during and after a health crisis. METHODS: An online survey was conducted at three times (April 2020, winter 2020/2021, and winter 2021/2022) during the COVID-19 pandemic in Austria. The sample included 160 healthcare workers at screening time 1, 1.361 healthcare workers at screening time 2, and 1.134 healthcare workers at screening time 3. The survey included COVID-19 work-related fears, satisfaction with the frontline work, and standardized inventories to assess psychosomatic symptoms, such as the Patient Health Questionnaire (PHQ-D). RESULTS: Psychosomatic symptoms were more common among women compared to men, and among frontline workers compared to non-frontline workers, especially during the course of the pandemic at t2 and t3. Self-reported scores of COVID-19 work-related fears were significantly associated with psychosomatic symptoms. Furthermore, in frontline workers, there was a significant association between the feeling of being safe and well-informed and psychosomatic symptoms. CONCLUSION: COVID-19 work-related fears and psychosomatic symptoms have been prevalent among healthcare workers throughout the pandemic. Feeling safe and informed appears to be essential to prevent psychosomatic symptoms, leading to a recommendation for employers in the healthcare sector to focus on communication and information. As frontline workers are especially prone to psychosomatic symptoms, more stress prevention programs for them will be essential to maintain productivity and reduce sick days and fluctuations in the healthcare system.
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COVID-19 , Masculino , Humanos , Feminino , COVID-19/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2 , Áustria/epidemiologia , Emoções , Pessoal de Saúde/psicologiaRESUMO
Background: Believing processes represent fundamental brain functions between cognition and emotion. Shortly before the introduction of a compulsory vaccination against COVID-19 in Austria, motives and underlying believing processes regarding the vaccination were collected in individuals with affective disorder (AD) and healthy controls (HC). Methods: 79 individuals with AD and 173 HC were surveyed online to assess believing processes with the parameters of the credition model (narratives, certainty, emotion, mightiness) about (1) the coronavirus itself and (2) why someone is vaccinated or not. In addition, we calculated congruence scores between content of narrative and type of emotion and divided the narrative content into positive, negative, and indifferent. Results: There were no differences in vaccination status between AD and HC. Higher levels of certainty were observed in HC compared to AD in both vaccinated and unvaccinated individuals. The effects were higher when asked about the motivation to vaccinate or not than about the coronavirus itself. In HC, more positive emotions and more congruence between emotions and narratives were reported during believing in their vaccination motives. No group differences were found in mightiness for both items. Independently from diagnosis, unvaccinated people had high levels of certainty and more negative emotions and narratives while believing in their motives for not getting vaccinated. Conclusion: When believing about the COVID-19 vaccination, individuals with AD were more uncertain and experienced fewer positive emotions than HC, although both groups did not differ in vaccination status. These effects were not that strong when believing about the coronavirus in general.
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The ongoing pandemic of coronavirus disease (COVID-19) is a global health crisis that has posed enormous pressure on workers in the health sector (WHS), having a massive impact on their mental health. In this study, we aimed to evaluate the sleep quality of WHS during the pandemic and compare frontline WHS to those who are not directly engaged in the care of COVID-19 patients. This cross-sectional, self-reported online survey assessed the sleep quality of WHS in Austria using the Pittsburgh Sleep Quality Index (PSQI). The same questionnaire was sent out two times. Due to the unequal sample and anonymity of the study participants, we analyzed the data of each time point separate from each other. The first study was conducted in April/May 2020, during the first lockdown in Austria (Study1), and the second study was conducted in July/August 2020, when the social restrictions were loosened (Study2). T-test was used to compare the mean values of PSQI scores between frontline vs. non-frontline WHS, while two two-way ANCOVAs were used to analyze differences in the PSQI mean scores (controlled for age) for male vs. female between frontline vs. non-frontline WHS. During the first lockdown in Austria (Study1) we identified a shorter sleep duration of frontline WHS compared to the non-frontline group, however the difference in global PSQI score between these groups was statistically not significant. In the period after loosened restrictions (Study2) the sleep quality, sleep latency, sleep duration, sleep efficiency and global PSQI score was worse in frontline WHS compared to the non-frontline WHS. Furthermore, female WHS scored higher in the PSQI indicating a worse sleep than male WHS. In addition, nurses and nursing assistants had a higher prevalence of poor sleep quality than other occupational groups. Our results indicate that the COVID-19 pandemic negatively impacts the sleep of WHS, affecting particularly frontline WHS. Preventive interventions aiming to promote good sleep quality in WHS during a healthcare crisis like this pandemic are essential to enhance resilience and mitigate the vulnerability of this specific population.
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COVID-19 , Pandemias , Humanos , Feminino , Masculino , COVID-19/epidemiologia , Qualidade do Sono , Estudos Transversais , Controle de Doenças TransmissíveisRESUMO
Background: The processes underlying believing have been labeled "creditions", which are important brain functions between emotion and cognition. Creditions are influenced by both internal and external factors, one of which is the coronavirus disease 2019 (COVID-19) pandemic and the vaccination against the disease. Methods: To investigate believing processes shortly before the implementation of a mandatory vaccination in Austria, both vaccinated and unvaccinated workers in the health sector (WHS) were surveyed in December 2021/January 2022. In total, 1,062 vaccinated and 97 unvaccinated WHS (920 females) completed the online survey. Beliefs were assessed using the parameters of the credition model (narrative, certainty, emotion, and mightiness) with regard to (1) the COVID-19 pandemic in general, and (2) the vaccination. Type of emotion and narrative were divided into positive, negative, and indifferent. Moreover, the congruence between emotion and narrative was calculated. Results: The vaccination rate of the sample was 91.6%, with a significantly higher percentage of men being in the group of vaccinated (21.1%) as compared to unvaccinated individuals (12.4%). Pertaining beliefs about the COVID-19 vaccination, unvaccinated WHS reported more negative and less positive emotions as well as content of narrative than vaccinated WHS. In addition, they showed higher levels of certainty as well as mightiness while believing and felt less sufficiently informed about governmental and workplace-related COVID-19 measures. The groups did not differ in the type of emotion or content of narrative in their beliefs about the pandemic in general. Conclusion: In conclusion, unvaccinated WHS had more negative and less positive emotions and thoughts than vaccinated WHS in their beliefs about the COVID-19 vaccination and their motivations for not having received it. They were more certain about their beliefs and felt stronger negative emotions in their beliefs compared to vaccinated individuals. Providing unvaccinated WHS with adequate information might be helpful in reducing their mental burden.
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BACKGROUND: Indoleamine 2,3-dioxygenase (IDO) activity is induced by cellular immune activation and therefore associated with inflammatory diseases, among others psychiatric disorders. This review aims to elucidate IDO activity reflected by kynurenine (KYN) to tryptophan (TRP) ratio in severe mental disorders. METHODS: A systematic literature search in MEDLINE and EMBASE was conducted targeting clinical trials in English language measuring KYN/TRP in individuals with a diagnosis of depression, bipolar disorder, or schizophrenia. RESULTS: Five out of 15 studies found higher levels of KYN/TRP in depression compared to a control group while the same amount found no difference. Moreover, three studies showed lower levels. In bipolar disorder, four out of six, and in psychotic disorders, three out of four trials found higher levels in patients compared to controls. There are only two studies comparing KYN/TRP in major depression and bipolar disorder, showing conflicting results. Eight studies focused on associations between KYN/TRP and clinical parameters, whereas two studies found positive correlations between KYN/TRP and severity of depressive symptoms. In contrast, four studies did not show an association. IDO activity during specific psychiatric treatment was analyzed by eight studies. CONCLUSION: In summary, this review demonstrates an inconsistency in the findings of studies investigating KYN/TRP in severe mental disorders. Although there are hints that inflammation associated with TRP catabolism towards the KYN pathway via elevated IDO activity seems likely, no conclusive statements can be drawn. Presumably, the consideration of influencing factors such as inflammatory processes, metabolic activities and psychological/neuropsychiatric symptoms are pivotal for a deeper understanding of the underlying mechanisms.
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Indolamina-Pirrol 2,3,-Dioxigenase , Transtornos Mentais , Humanos , Transtornos Mentais/tratamento farmacológicoRESUMO
Throughout the COVID-19 pandemic, mental health of individuals with bipolar disorders (BD) is potentially more vulnerable, especially regarding COVID-19-related regulations and associated symptomatic changes. A multicentric online study was conducted in Austria, Germany, and Denmark during the COVID-19 pandemic. Overall, data from 494 participants were collected (203 individuals with BD, 291 healthy controls (HC)). Participants filled out questionnaires surveying emotional distress due to social distancing, fear of COVID-19, and the Brief Symptom Inventory-18 to assess symptom severity at four points of measurement between 2020 and 2021. General linear mixed models were calculated to determine the difference between the groups in these pandemic specific factors. Individuals with BD reported higher distress due to social distancing than HC, independently of measurement times. Fear of COVID-19 did not differ between groups; however, it was elevated in times of higher infection and mortality due to COVID-19. Individuals with BD reported higher psychiatric symptom severity than HC; however, symptom severity decreased throughout the measured time in the pandemic. Overall, individuals with BD experienced more distress due to the COVID-19 situation than HC. A supportive mental health system is thus recommended to ensure enhanced care, especially in times of strict COVID-19-related regulations.
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Transtorno Bipolar , COVID-19 , Angústia Psicológica , Áustria/epidemiologia , Transtorno Bipolar/epidemiologia , COVID-19/epidemiologia , Dinamarca/epidemiologia , Alemanha/epidemiologia , Humanos , Pandemias , Distanciamento FísicoRESUMO
Depression is one of the most severe psychiatric disorders and affects patients on emotional, physical, and cognitive levels. Comorbid somatic conditions, such as cardiovascular diseases, are frequent and affect the quality of life, as well as mortality. Underlying maladaptive autonomic nervous system regulation influences emotional and cognitive processes. This study, thus, aimed to investigate the relationship among heart rate variability (HRV), self-reported coping strategies, executive function, and inhibition in individuals with psychiatric disorders. Data of 97 patients treated in a multi-professional psychiatric rehabilitation center for 6 weeks were analyzed. Subjects underwent psychological tests (Stress Coping Style Questionnaire, Emotional Competence Questionnaire, and Becks Depression Inventory-II), a cognitive test (Color-Word Interference Test), and a 24 h electrocardiogram to record HRV. Patients with higher depression scores had significantly lower HRVs and decreased self-reported abilities for stress coping. Depression severity did not affect cognitive inhibitory abilities. HRV was related to neither coping strategies nor cognitive inhibition abilities. However, lower HRV was related to higher values of Negative Stress Coping (ß = −0.21, p < 0.05). This relationship was fully mediated by depression severity (−4.79, 95% CI: −8.72, −0.72). HRV is not related to quantitative cognitive inhibition, but to the self-reported ability to cope with negative emotions in individuals with psychiatric disorders.
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Affective disorders such as major depressive disorder and bipolar disorder are associated with higher infection rates and a more severe course of coronavirus disease (COVID-19). In turn, COVID-19 could trigger mental disease relapse. Vaccinations lead to a reduction of infections and the prevention of severe courses. This work aims to survey the willingness of individuals with affective disorders to get vaccinated and concerns about vaccinations. METHODS: An online study (April-May 2021) assessed the current infection and vaccination rate amongst individuals with affective disorder in Austria by surveying attitudes towards the vaccination, the willingness to get vaccinated soon and possible reasons for decision. The analyses included 59 individuals with affective disorders and 59 healthy controls, matched for sex and age. RESULTS: There was an overall high willingness to get vaccinated against COVID-19. Individuals with affective disorders were more skeptical about vaccinations in general but there was no significant difference between the groups in the willingness to get vaccinated against COVID-19. In both groups reasons for waiting were mainly fears of acute and/or long-term side effects and the fast development of the vaccines. LIMITATIONS: It was a cross sectional design. Due to the online design, no objective rating of current psychopathological symptoms was assessed. Willingness to get vaccinated in general and against COVID-19 in particular were self-created variables, whereas item statistics and factor analysis were conducted. DISCUSSION: Because of the higher risk for individuals with affective disorders, preventive strategies like vaccinating should be promoted in this group. It is important to help individuals with AD to overcome barriers such as negative beliefs and concerns about acute and/or long-term side effects.
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BACKGROUND: The prevalence of metabolic syndrome and overweight/obesity is increased in bipolar disorder (BD) compared to the general population and is related to suicidality. The aim of this study was to examine the association between both the rate of suicidal ideation and suicide attempts and metabolic variables in individuals with BD. METHODS: Anthropometric measures, socio-demographic data, suicide history and serum lipid levels were measured in 215 individuals with BD. Individuals were divided into normal weight, overweight and obese according to their body mass index (BMI), and metabolic syndrome was assessed using "The International Diabetes Federation"-criteria. RESULTS: Of the 215 individuals studied, 80.9% reported suicidal ideation, 35.3% reported at least one suicide attempt and 30.7% were diagnosed with metabolic syndrome. Both metabolic syndrome and BMI were not related to suicide attempts. However, individuals with normal weight had more suicidal ideation than overweight individuals, while obese individuals did not differ from either group. Furthermore, there was no association between suicide attempts or suicidal ideation and serum lipid levels. LIMITATIONS: The cross-sectional design of the study, a non-standardized questionnaire for suicidality, and not controlling the medication intake are limiting factors. CONCLUSION: Contrary to expectations, a difference was found in the BMI categories and suicidal ideation, but not suicide attempts. Serum lipid levels were found to be unsuitable as possible biomarkers for suicidality in individuals with BD. Special attention should be paid to suicidal ideation and BMI rather than metabolic syndrome or lipid values when treating suicidal individuals with BD.
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Transtorno Bipolar , Síndrome Metabólica , Suicídio , Transtorno Bipolar/epidemiologia , Estudos Transversais , Humanos , Lipídeos , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Fatores de Risco , Ideação SuicidaRESUMO
Bipolar disorder (BD) is associated with impairments in cognitive functions, in which metabolic factors, e.g., overweight, seem to play a significant role. The aim of this study was to investigate the association between nutritional factors and cognitive performance in euthymic individuals with BD. A study cohort of 56 euthymic individuals with BD was compared to a sample of 53 mentally healthy controls. To assess cognitive function, the following tests were applied: California Verbal Learning Test, Trail Making Test A/B, d2 Test of Attention-Revised, and Stroop's Color-Word Interference Test. Furthermore, a 4-day food record was processed to evaluate dietary intake of macronutrients, specific micronutrients, and food diversity. Body mass index and waist to height ratio were calculated to assess overweight and central obesity. Results showed no nutritional differences between individuals with BD and controls. Individuals with BD performed worse in the d2 test than controls. Hierarchical regression analyses yielded no association between cognitive and nutritional parameters. However, waist to height ratio was negatively correlated with almost all cognitive tests. Central obesity seems to affect cognitive functioning in BD, while the lack of finding differences in nutritional data might be due to problems when collecting data and the small sample size. Consequently, further studies focusing on objectively measuring food intake with adequate sample size are needed.
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Transtorno Bipolar , Sobrepeso , Atenção , Transtorno Bipolar/complicações , Transtorno Bipolar/psicologia , Cognição , Humanos , Testes Neuropsicológicos , Sobrepeso/complicaçõesRESUMO
The COVID-19 pandemic affects both mentally healthy and ill individuals. Individuals with bipolar disorder (BD) constitute an especially vulnerable group. A multicentric online study was conducted in Austria, Denmark, and Germany after the first lockdown phase in 2020. In total, 117 healthy controls (HC) were matched according to age and sex to 117 individuals with BD. The survey included the Brief Symptom Inventory-18, Beck Depression Inventory-2, Pittsburgh Sleep Quality Index, and a self-constructed questionnaire assessing COVID-19 fears, emotional distress due to social distancing, lifestyle, and compliance to governmental measures. In individuals with BD, increased symptoms of depression, somatization, anxiety, distress due to social distancing, and poorer sleep quality were related to emotional distress due to social distancing. The correlation between emotional distress due to social distancing and anxiety showed 26% of shared variance in BD and 11% in HC. Negative lifestyle changes and lower compliance with COVID-19 regulatory measures were more likely to be observed in individuals with BD than in HC. These findings underscore the need for ongoing mental health support during the pandemic. Individuals with BD should be continuously supported during periods of social distancing to maintain a stable lifestyle and employ strategies to cope with COVID-19 fears.