Periodontal condition and levels of bacteria associated with periodontitis in individuals with bipolar affective disorders: A case-control study.

OBJECTIVE: To evaluate the epidemiological and microbiological aspects of the potential association between bipolar affective disorder (BAPD) and periodontitis. METHODOLOGY: The present case-control study comprised 176 individuals with BAPD and 176 controls. All individuals underwent a complete full-mouth periodontal examination and microbiological sampling. Data on bleeding on probing, probing depth, and clinical attachment level in all present teeth were recorded. Quantification of total bacterial load and Aggregatibacter actinomycetemcomitans, Treponema denticola, and Porphyromonas gingivalis counts were performed through qPCR. Data were analyzed using univariate analysis, Spearman correlation and multivariate logistic regression. RESULTS: The prevalence of periodontitis was 39.7% among controls and 58.5% among individuals with BAPD (OR = 2.13; 95% CI 1.39-3.27). A. actinomycetemcomitans and P. gingivalis counts were significantly higher in individuals with BPAD and periodontitis. The final multivariate logistic regression revealed that periodontitis was strongly associated with the total bacterial load (OR = 1.91; 95% IC = 1.0-1.99; P < 0.001) and the depressive phase of BPAD (OR = 28.94; 95% IC = 4.44-177.27; P < 0.001). CONCLUSION: BAPD was associated with increased risk for periodontitis. Individuals with BPAD presented higher levels of A. actinomycetemcomitans and P. gingivalis, suggesting that periodontitis could be a co-morbidity frequently found in individuals with BAPD.

An association study between the Val66Met polymorphism of the BDNF gene and postpartum depression.

Postpartum depression disorder (PPD) is a severe illness affecting around 15% of deliveries. Several evidences suggest that PPD is, at least, partially genetic determined. The gene encoding BDNF is a strong candidate for pathogenesis of PPD since that it has been observed decrease of serum BDNF in patients suffering from PPD. The gene encoding BDNF has a polymorphism (Val66Met) that alters the regulated protein secretion; the methionine variant being associated with insufficient secretion compared with the Valine variant. We hypothesized that BDNF gene Val66Met polymorphism could be associated with PPD. We assessed 227 subjects randomly selected who had delivery at a maternity hospital using EPDS. Differences in genotype frequency were calculated by chi (2) test. Logistic Regression Analyses was performed to verify the existence of interaction between biological, psychiatric and environmental variables and PPD. Difference between groups was tested with Student's t test. Tests were two-tailed and results significant when p < or = 0.05. No difference in BDNF genotype distribution was observed between the depressed and non-depressed women. Educational level, stress during pregnancy, bipolar disorder and anxiety was strongly associated with PPD. We were not able to show an association between BDNF polymorphisms and PPD. Further studies are necessary to both of confirm our results and improve validity of PPD diagnosis.

Integrative Understanding of Familial Impulsivity, Early Adversity and Suicide Risk.

Introduction: Impulsivity is a core characteristic of bipolar disorder and it was observed as elevated in individuals with the disorder and in their relatives. Both impulsivity and history of maltreatment are risk factors for suicide attempts, however, these two key variables may not be independent, given the fact that parental impulsivity and associated social context could increase the risk of child maltreatment. In this study it was examined the association between the impulsivity of relatives and child maltreatment taking into consideration the conjoint and unique effects of these two variables on the risk of suicide attempts among the patients. Materials and Methods: Participants of the study consisted of 117 patients diagnosed with bipolar disorder and 25 first-degree relatives. Linear regression model was conducted to describe associations between facets of impulsivity of relatives and levels of child maltreatment reported by patients. The independent associations of suicide attempt history with the dimensions of impulsivity of the patient and maltreatment were tested by multinomial logistic regression. Results: Impulsivity of relatives and, more specifically, inhibitory control can predict the maltreatment of the patient. Inhibitory control and emotional abuse were related, conjointly, to a greater likelihood of having a history of more than one suicide attempt. Discussion: Considering that the impulsivity of relatives predicts child maltreatment, it is possible that a genetically shared impulsivity is an underlying feature associated with the history of multiple suicide attempts. These findings highlight the importance of considering child maltreatment, impulsivity and suicide attempt history in integrative models.

Factor Analysis of the Brazilian Version of UPPS Impulsive Behavior Scale.

Objective: To examine the internal consistency and factor structure of the Brazilian adaptation of the UPPS Impulsive Behavior Scale. Methods: UPPS is a self-report scale composed by 40 items assessing four factors of impulsivity: (a) urgency, (b) lack of premeditation; (c) lack of perseverance; (d) sensation seeking. In the present study 384 participants (278 women and 106 men), who were recruited from schools, universities, leisure centers and workplaces fulfilled the UPPS scale. An exploratory factor analysis was performed by using Varimax factor rotation and Kaiser Normalization, and we also conducted two confirmatory analyses to test the independency of the UPPS components found in previous analysis. Results: Results showed a decrease in mean UPPS total scores with age and this analysis showed that the youngest participants (below 30 years) scored significantly higher than the other groups over 30 years. No difference in gender was found. Cronbach's alpha, results indicated satisfactory values for all subscales, with similar high values for the subscales and confirmatory factor analysis indexes also indicated a poor model fit. The results of two exploratory factor analysis were satisfactory. Conclusion: Our results showed that the Portuguese version has the same four-factor structure of the original and previous translations of the UPPS.

Neural correlates of hallucinations in bipolar disorder.

OBJECTIVE: Approximately one-half of all patients affected by bipolar disorder present with psychotic features on at least one occasion. Several studies have found that alterations in the activity of mesolimbic and prefrontal regions are related to aberrant salience in psychotic patients. The aim of the present study was to investigate the structural correlates of a history of hallucinations in a sample of euthymic patients with bipolar I disorder (BD-I). METHODS: The sample consisted of 21 euthymic patients with BD-I and no comorbid axis I DSM-IV-TR disorders. Voxel based morphometry (VBM) was used to compare patients with and without a lifetime history of hallucinations. Preprocessing was performed using the Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) algorithm for VBM in SPM8. Images were processed using optimized VBM. RESULTS: The main finding of the present study was a reduction in gray matter volume in the right posterior insular cortex of patients with BD-I and a lifetime history of hallucinations, as compared to subjects with the same diagnosis but no history of hallucinations. CONCLUSIONS: This finding supports the presence of abnormalities in the salience network in BD patients with a lifetime history of hallucinations. These alterations may be associated with an aberrant assignment of salience to the elements of one's own experience, which could result in psychotic symptoms.

Depression rather than liver impairment reduces quality of life in patients with hepatitis C.

OBJECTIVE: Patients with chronic hepatitis C (CHC) have a poorer quality of life than those with other chronic liver diseases. However, some of the factors that determine health-related quality of life (HRQOL) in these patients, such as the degree of liver fibrosis, are still controversial. Therefore, the aim of the present study was to investigate the impact of CHC on HRQOL by conducting clinical, psychiatric, and sociodemographic evaluations. METHODS: One hundred and twenty-four consecutive patients attending a referral center for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview, the Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Multiple linear regression analyses were used to quantify independent associations between HRQOL and the clinical, psychiatric, and sociodemographic variables of interest. RESULTS: Reduced HRQOL was independently associated with major depressive disorder (MDD) and with elevated levels of alanine aminotransferase, but was not associated with hepatic cirrhosis. CONCLUSIONS: MDD rather than the grade of liver fibrosis was strongly associated with HRQOL impairment in patients with CHC. These findings highlight that, in patients with CHC, the psychological effects of the disease deserve more attention and the implementation of integrated medical, psychiatric, and psychological care may be helpful.

Sensorimotor performance in euthymic bipolar disorder: the MPraxis (PennCNP) analysis.

BACKGROUND: Sensorimotor deficits are an important phenomenological facet observed in patients with bipolar disorder (BD). However, there is little research on this topic. We hypothesize that the MPraxis test can be used to screen for motor impairments in BD aiming movements. METHOD: The MPraxis, which is a quick and easy-to-apply computerized test, measures sensorimotor control. During the test, the participant must move the computer mouse cursor over an ever-shrinking green box and click on it once. We predict that the MPraxis test is capable of detecting differences in sensorimotor performance between patients with BD and controls. We assessed 21 euthymic type I BD patients, without DSM-IV-TR Axis I comorbidity, and 21 healthy controls. RESULTS AND CONCLUSIONS: Compared to the controls, the patients with BD presented a lower response time in their movements in all conditions. Our results showed sensorimotor deficits in BD and suggested that the MPraxis test can be used to screen for motor impairments in patients with euthymic BD.

A kinematic analysis of manual aiming control on euthymic bipolar disorder.

Motor deficits in tasks that require force steadiness or scaling of movement velocity have been found in bipolar disorder (BD). A potential explanation for these results is the abnormal functioning of the frontostriatal circuitry. We designed this study to investigate the possible impairments in a manual aiming task. Participants comprised 15 euthymic BD patients and 15 healthy controls, who performed 100 trials of a goal-directed manual movement with a non-inking pen on a digitizing tablet. Four different conditions of execution were required. The control condition appeared on the computer screen in 70% of the trials, and the other three conditions, (a) distractor, (b) inhibition of response and (c) higher index of difficulty, each appeared in 10% of the trials. Compared to the controls, the BD patients were less fluent in their movements, relied more heavily on visual feedback to control their manual movements and presented a lower spatial accuracy. We found that motor deficits in euthymic BD were observed in the kinematic analysis of manual aiming. Our findings are consistent with the hypothesis of abnormal functioning of the frontostriatal circuitry in euthymic BD.

Association study of tryptophan hydroxylase 2 gene polymorphisms in bipolar disorder patients with panic disorder comorbidity.

Frequent comorbidity between panic disorder (PD) and mood disorders has been widely reported in clinical and epidemiological studies and, recently, an increasing attention has been paid to the cooccurrence of PD and bipolar disorder (BD). Several studies have shown that an imbalance of serotonin activity could be related to panic symptoms. Tryptophan hydroxylase 2 (TPH2) are plausible candidates for the association with PD. The aim of this study is to investigate a possible association between TPH2 gene polymorphisms and the PD comorbidity susceptibility.Our sample consisted of 515 patients; 274 patients with BD (subtypes I and II), including 45 patients with lifetime panic disorder comorbidity and 241 controls. These patients were genotyped for eight tagging single nucleotide polymorphisms of the gene of human TPH2. We found significant differences between patients with BD, with panic disorder comorbidity, and controls in the allelic analysis (rs4448731, P=0.0069; rs4565946, P=0.0359; rs4760820, P=0.0079; rs1487275, P=0.0439) and genotypic analysis (rs4448731, P=0.011; rs4760820, P=0.0259). We also identified significant differences between patients with BD, with and without panic disorder comorbidity in the allelic analysis (rs4448731, P=0.004; rs4565946, P=0.011; rs11179000, P=0.031; rs4760820, P=0.018; rs1487275, P=0.038; rs10879357, P=0.023) and genotypic analysis (rs4448731, P=0.004; rs4565946, P=0.010; rs4760820, P=0.023; rs10879357, P=0.052). The haplotype analysis in the group of patients with BD, with and without panic disorder comorbidity, was also significant (rs4448731-rs4565946, P=0.0190; rs4448731-rs4565946, P=0.0220; rs10506645-rs4760820, P=0.0360). Further studies are needed to replicate the positive association that we observed.

Neural correlates of hallucinations in bipolar disorder

Objective: Approximately one-half of all patients affected by bipolar disorder present with psychotic features on at least one occasion. Several studies have found that alterations in the activity of mesolimbic and prefrontal regions are related to aberrant salience in psychotic patients. The aim of the present study was to investigate the structural correlates of a history of hallucinations in a sample of euthymic patients with bipolar I disorder (BD-I). Methods: The sample consisted of 21 euthymic patients with BD-I and no comorbid axis I DSM-IV-TR disorders. Voxel based morphometry (VBM) was used to compare patients with and without a lifetime history of hallucinations. Preprocessing was performed using the Diffeomorphic Anatomical Registration through Exponentiated Lie Algebra (DARTEL) algorithm for VBM in SPM8. Images were processed using optimized VBM. Results: The main finding of the present study was a reduction in gray matter volume in the right posterior insular cortex of patients with BD-I and a lifetime history of hallucinations, as compared to subjects with the same diagnosis but no history of hallucinations. Conclusions: This finding supports the presence of abnormalities in the salience network in BD patients with a lifetime history of hallucinations. These alterations may be associated with an aberrant assignment of salience to the elements of one’s own experience, which could result in psychotic symptoms.

Genetic variations in FOXO3A are associated with Bipolar Disorder without confering vulnerability for suicidal behavior.

BACKGROUND: Genetic variation plays an important role in Bipolar Disorder (BD) and suicide susceptibility. However, little is known about the genetic influence on the risk of suicide, particularly in BD patients. Since FOXO3A plays a role in distinct mood-relevant behavioral processes, this gene could be a novel gene candidate for BD. Thus, we investigated whether FOXO3A polymorphisms are associated with BD and suicidal behavior in BD patients. METHODS: TaqMan genotyping was used to detect FOXO3A SNPs in 273 BD patients and 264 control subjects. RESULTS: Three SNPs (rs1536057, rs2802292 and rs1935952) were associated with BD, but none was positively linked with suicidal behavior. LIMITATION: A systematic evaluation within the whole FOXO3A gene and drug treatment in patients was not performed. CONCLUSIONS: These data suggest that FOXO3A is a novel susceptibility locus for BD, but not for suicidal behavior in BD patients. These results may contribute to a better understanding of the BD genetics.

Summaries from the XVIII World Congress of Psychiatric Genetics, Athens, Greece, 3-7 October 2010.

The XVIIIth World Congress of Psychiatric Genetics, sponsored by The International Society of Psychiatric Genetics took place in Athens, Greece on October 3-7, 2010. Approximately 950 participants gathered to discuss the latest findings in this rapidly advancing field. The following report was written by junior travel awardees, as well as others who were volunteers from student meeting attendees. Each was assigned sessions as rapporteurs. This report represents some of the areas covered in oral presentation during the conference, and reports on some of the notable major new findings described at this 2010 World Congress of Psychiatric Genetics.

Depression rather than liver impairment reduces quality of life in patients with hepatitis C

Objective: Patients with chronic hepatitis C (CHC) have a poorer quality of life than those with other chronic liver diseases. However, some of the factors that determine health-related quality of life (HRQOL) in these patients, such as the degree of liver fibrosis, are still controversial. Therefore, the aim of the present study was to investigate the impact of CHC on HRQOL by conducting clinical, psychiatric, and sociodemographic evaluations. Methods: One hundred and twenty-four consecutive patients attending a referral center for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview, the Hamilton Depression Rating Scale, the Hospital Anxiety and Depression Scale, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Multiple linear regression analyses were used to quantify independent associations between HRQOL and the clinical, psychiatric, and sociodemographic variables of interest. Results: Reduced HRQOL was independently associated with major depressive disorder (MDD) and with elevated levels of alanine aminotransferase, but was not associated with hepatic cirrhosis. Conclusions: MDD rather than the grade of liver fibrosis was strongly associated with HRQOL impairment in patients with CHC. These findings highlight that, in patients with CHC, the psychological effects of the disease deserve more attention and the implementation of integrated medical, psychiatric, and psychological care may be helpful. .

A neurobiologia do suicídio: evidências do papel do sistema serotoninérgico / Neurobiology of suicide: evidences of the role of serotonergic system

O suicídio figura entre as principais causas de morte nos países industrializados e, a despeito de tentativas de prevenção, suas taxas são crescentes, o que tem estimulado as pesquisas na biologia do suicídio, com o objetivo de auxiliar o clínico na identificação do suicida em potencial. Existem hoje muitas evidências oriundas de estudos com diferentes metodologias (estudos postðmortem, estudos de concentrações liquóricas de 5ðHIAA, estudos neuroendocrinológicos) mostrando que anormalidades no sistema serotoninérgico estariam associadas ao comportamento suicida. Hoje, o foco principal das pesquisas, após as evidências dos estudos de epidemiologia genética de que o suicídio seria, pelo menos parcialmente, geneticamente determinado, são os estudos de genética molecular. Esta abordagem, apesar de estar ainda em fase inicial e de ter resultados às vêzes inconsistentes, é promissora, e seus resultados sugerem que, pelo menos em parte, fatores genéticos influenciam o comportamento suicida através do sistema serotoninérgico. As pesquisas devem continuar, principalmente focando a associação de características psicopatológicas básicas, potencialmente associadas ao comportamento suicida, como a impulsividade, e sua associação com genes ligados à função serotoninérgica, assim como estudos postðmortem que podem examinar a expressão gênica e suas proteínas