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  • 1. Boden, Robert
    et al.
    Molina, E.
    Jernberg, T.
    Kieler, H.
    Lindahl, Bertil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Myocardial infarction survival in patients with bipolar disorder or schizophrenia spectrum disorders- a nationwide cohort study2014In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 16, p. 62-63Article in journal (Other academic)
  • 2.
    Cederlöf, Martin
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bergen, Sarah E.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Långström, Niklas
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Swedish Prison and Probation Service R andD, Norrköping, Sweden.
    Larsson, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Boman, Marcus
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Craddock, Nick
    Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom .
    Östberg, Per
    Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, Sweden; Department of Speech-Language Pathology, Karolinska University Hospital, Huddinge, Sweden .
    Lundström, Sebastian
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden; Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden .
    Sjölander, Arvid
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Nordlind, Klas
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden .
    Landén, Mikael
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden .
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    The association between Darier disease, bipolar disorder, and schizophrenia revisited: a population-based family study2015In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 17, no 3, p. 340-344Article in journal (Refereed)
    Abstract [en]

    Objectives: Darier disease is an autosomal dominant skin disorder caused by mutations in the ATPase, Ca++ transporting, cardiac muscle, slow twitch 2 (ATP2A2) gene and previously reported to cosegregate with bipolar disorder and schizophrenia in occasional pedigrees. It is, however, unknown whether these associations exist also in the general population, and the objective of this study was to examine this question.

    Methods: We compared a national sample of individuals with Darier disease and their first-degree relatives with matched unexposed individuals from the general population and their first-degree relatives, respectively. To examine risks for bipolar disorder and schizophrenia, risk ratios and 95% confidence intervals (CIs) were estimated using conditional logistic regressions.

    Results: Individuals with Darier disease had a 4.3 times higher risk of being diagnosed with bipolar disorder (95% CI: 2.6-7.3) and a 2.3 times higher risk of being diagnosed with schizophrenia (95% CI: 1.1-5.2) than matched individuals from the general population. Relatives of individuals with Darier disease had a 1.6 times higher risk of having bipolar disorder (95% CI: 1.1-2.5) than relatives of matched individuals from the general population, but no increased risk of schizophrenia (risk ratio = 0.8, 95% CI: 0.4-1.8).

    Conclusions: The association between Darier disease and bipolar disorder is manifest also in the population, and our data suggest that genetic variability within the ATP2A2 gene that causes Darier disease also confers susceptibility for bipolar disorder. The Darier-causing mutations merit additional attention in molecular genetic research on bipolar disorder.

  • 3. Ceulemans, Shana
    et al.
    De Zutter, Sonia
    Heyrman, Lien
    Norrback, Karl-Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nordin, Annelie
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nilsson, Lars-Goran
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Del-Favero, Jurgen
    Claes, Stephan
    Evidence for the involvement of the glucocorticoid receptor gene in bipolar disorder in an isolated northern Swedish population2011In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 13, no 7-8, p. 614-623Article in journal (Refereed)
    Abstract [en]

    Objectives: Dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis is one of the most consistent findings in the pathophysiology of mood disorders. The potential role of genes related to HPA axis function has been investigated extensively in major depression. However, in bipolar disorder (BPD) such studies are scarce. We performed a systematic HapMap-based association study of six genes crucial for HPA axis function in relation to BPD.

    Methods: Haplotype tagging single nucleotide polymorphisms (htSNPs) were selected in order to identify all haplotypes with a frequency of more than 1% in the genes encoding the glucocorticoid receptor (GR), mineralocorticoid receptor (MR), corticotrophin releasing hormone receptor 1 (CRH-R1) and 2 (CRH-R2), CRH binding protein (CRH-BP), and FK binding protein 5 (FKBP5). This resulted in a total selection of 225 SNPs that were genotyped and analyzed in 309 BPD patients and 364 matched control individuals all originating from an isolated northern Swedish population.

    Results: Consistent evidence for an association with BPD was found for NR3C1, the gene encoding GR. Almost all SNPs in two adjacent haplotype blocks contributed to the positive signal, comprised of significant single marker, sliding window, and haplotype-specific p-values. All these results point to a moderately frequent (10-15%) susceptibility haplotype covering the entire coding region and 3 > untranslated region (UTR) of NR3C1.

    Conclusions: This study contributes to the growing evidence for a role of the glucocorticoid receptor gene (NR3C1) in vulnerability to mood disorders, and BPD in particular, and warrants further in vitro investigation of the at-risk haplotypes with respect to disease etiology. However, this association might be restricted to this specific population, as it is observed in a rather small sample from an isolated population without replication, and data from large meta-analyses for genome-wide association studies in BPD do not show the GR as a very strong candidate.

  • 4. Ceulemans, Shana
    et al.
    De Zutter, Sonia
    Heyrman, Lien
    Norrback, Karl-Fredrik
    Nordin, Annelie
    Nilsson, Lars-Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Adolfsson, Rolf
    Del-Favero, Jurgen
    Claes, Stephan
    Evidence for the involvement of the glucocorticoid receptor gene in bipolar disorder in an isolated northern Swedish population2011In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 13, no 7-8, p. 614-623Article in journal (Refereed)
    Abstract [en]

    Objectives: Dysfunction of the hypothalamus-pituitary-adrenal (HPA) axis is one of the most consistent findings in the pathophysiology of mood disorders. The potential role of genes related to HPA axis function has been investigated extensively in major depression. However, in bipolar disorder (BPD) such studies are scarce. We performed a systematic HapMap-based association study of six genes crucial for HPA axis function in relation to BPD. Methods: Haplotype tagging single nucleotide polymorphisms (htSNPs) were selected in order to identify all haplotypes with a frequency of more than 1% in the genes encoding the glucocorticoid receptor (GR), mineralocorticoid receptor (MR), corticotrophin releasing hormone receptor 1 (CRH-R1) and 2 (CRH-R2), CRH binding protein (CRH-BP), and FK binding protein 5 (FKBP5). This resulted in a total selection of 225 SNPs that were genotyped and analyzed in 309 BPD patients and 364 matched control individuals all originating from an isolated northern Swedish population. Results: Consistent evidence for an association with BPD was found for NR3C1, the gene encoding GR. Almost all SNPs in two adjacent haplotype blocks contributed to the positive signal, comprised of significant single marker, sliding window, and haplotype-specific p-values. All these results point to a moderately frequent (10–15%) susceptibility haplotype covering the entire coding region and 3? untranslated region (UTR) of NR3C1. Conclusions: This study contributes to the growing evidence for a role of the glucocorticoid receptor gene (NR3C1) in vulnerability to mood disorders, and BPD in particular, and warrants further in vitro investigation of the at-risk haplotypes with respect to disease etiology. However, this association might be restricted to this specific population, as it is observed in a rather small sample from an isolated population without replication, and data from large meta-analyses for genome-wide association studies in BPD do not show the GR as a very strong candidate.

  • 5.
    Chudal, Roshan
    et al.
    Department of Child Psychiatry, University of Turku, Turku, Finland.
    Gissler, Mika
    Nordic Council of Ministers, Nordic School of Public Health NHV. Department of Child Psychiatry, University of Turku, Turku, Finland / National Institute for Health and Welfare, Helsinki, Finland.
    Sucksdorf, Dan
    Department of Child Psychiatry, University of Turku, Turku, Finland.
    Lehti, Venla
    Department of Child Psychiatry, University of Turku, Turku, Finland.
    Suominen, Auli
    Department of Child Psychiatry, University of Turku, Turku, Finland.
    Hinkka- Yli-Salomaki, Susanna
    Department of Child Psychiatry, University of Turku,.
    Brown, Alan S
    Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA, / Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA.
    Sourander, Andre
    Department of Child Psychiatry, University of Turku, Turku, Finland / Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA / Regional Centre for Child and Youth Mental Health and Child Welfare, University of Tromsø, Tromsø, Norwa.
    Parental age and the risk of bipolar disorders2014In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, ISSN 1398-5647Article in journal (Refereed)
    Abstract [en]

    Objectives:Studies on the association between parental age and bipolardisorder (BPD) are scarce and with inconsistent findings. The aim of thisstudy was to examine the association of parental age and age differencebetween parents with risk of BPD in offspring.Methods:This nested case–control study identified 1,861 cases ofindividuals with BPD born in Finland during 1983–1998 and diagnosedby the end of 2008, and 3,643 sex- and date of birth-matched controlsfrom nationwide population-based registers. Conditional logisticregression was used to examine the association adjusting for potentialconfounding due to age of the other parent, parental psychiatric history,educational level, and place of birth.Results:A U-shaped association of unadjusted odds ratios (ORs) forBPD risk was seen in different paternal age categories, with the oddsincreasing at both ends of the age spectrum. In the adjusted analyses,offspring of fathers aged≥50 years had a 2.8-fold increased odds[OR=2.84, 95% confidence interval (CI): 1.32–6.12] of BPD ascompared to those with fathers aged 30–34 years. The odds wereincreased 1.3-fold (OR=1.35, CI: 1.06–1.72) in fathers aged 20–24 years. No significant association was found between maternal ageand BPD in the adjusted analyses. Age difference between parents wasnot associated with BPD.Conclusions:The increased risk of BPD in offspring of the youngest andoldest fathers in the study suggests the involvement of differentbiological and psychosocial factors at the two ends of the paternal agespectrum. These findings may be significant in the context of advancingparental age in recent times.

  • 6. Engström, C
    et al.
    Brändström, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Sigvardsson, S
    Cloninger, R
    Nylander, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Bipolar disorder. II: Personality and age of onset2003In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 5, no 5, p. 340-348Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to examine whether personality i.e. temperament and character interacts with age of onset in bipolar disorder. Methods: Bipolar patients were recruited among in- and outpatients from lithium dispensaries of northern Sweden. Patients were diagnosed according to DSM-IV criteria for bipolar disorder type I and II. Temperament and Character Inventory (TCI) was used for measuring personality. TCI was administered to 100 lithium treated bipolar patients and 100 controls. Results: Treatment response was significantly lower (p = 0.005) in patients with early onset compared with late onset. Family history (p = 0.013) and suicide attempts (p = 0.001) were also significantly more common in patients with early onset. Further, patients with early onset were significantly higher (p = 0.045) in the temperament factor harm avoidance (HA) than patients with late onset, but the difference was weak. Patients with early onset had more fear of uncertainty (HA2, P = 0.022) and were more shy (HA3, p = 0.030). Bipolar I patients showed similar results as those in the total bipolar group (I and II), with significantly higher HA (p = 0.019, moderate difference), HA2 (p = 0.015) and HA3 (p = 0.043) in patients with early onset compared with late onset. Bipolar II patients showed no differences between early and late age of onset but the groups are small and the results are therefore uncertain. Conclusions: Early age of onset in bipolar disorder was correlated to an increase in severity, family history, poorer treatment response and poorer prognosis. Early onset was also correlated to personality.

  • 7.
    Engström, Christer
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Brändström, Sven
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Sigvardsson, Sören
    Cloninger, C Robert
    Nylander, Per-Olof
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry.
    Bipolar disorder. III: Harm avoidance a risk factor for suicide attempts2004In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 6, no 2, p. 130-138Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to examine whether personality, i.e. temperament and character influence suicide attempts in bipolar patients. Methods: Bipolar patients were recruited from lithium dispensaries. Temperament and character inventory (TCI) was administered to 100 euthymic bipolar patients and 100 controls. Results: Age of onset was significantly lower in patients with suicide attempts in the total bipolar group (I and II) and bipolar I patients compared with patients without suicide attempts. Bipolar (I and II) and bipolar I patients with suicide attempts were significantly higher in harm avoidance (HA) and reward dependence compared with patients without suicide attempts. Patients (I and II) with suicide attempts had significantly more anticipatory worry, fatigability and asthenia than patients without suicide attempts. Bipolar I patients with suicide attempts had significantly more fatigability and asthenia and were more dependent than patients without suicide attempts. HA was lowest in patients with no suicide attempts and no family history of suicide, higher in patients with family history of suicide or patients with suicide attempts, and significantly highest in patients with suicide attempts and family history of suicide. Patients with suicide attempts and family history of suicide had more anticipatory worry, fatigability and asthenia. Bipolar disorder was significantly correlated to HA and suicide attempts to HA and PS. Family history of suicide and gender were significantly correlated to suicide attempts. Conclusions: Age of onset, HA, PS, gender and family history of suicide had a moderate to very strong effect on suicide attempts in bipolar patients. © Blackwell Munksgaard, 2004.

  • 8. Engström, Christer
    et al.
    Brändström, Sven
    Sigvardsson, Sören
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Cloninger, C Robert
    Nylander, Per-Olof
    Bipolar disorder. III: harm avoidance a risk factor for suicide attempts2004In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 6, no 2, p. 130-138Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to examine whether personality, i.e. temperament and character influence suicide attempts in bipolar patients.

    Methods: Bipolar patients were recruited from lithium dispensaries. Temperament and character inventory (TCI) was administered to 100 euthymic bipolar patients and 100 controls.

    Results: Age of onset was significantly lower in patients with suicide attempts in the total bipolar group (I and II) and bipolar I patients compared with patients without suicide attempts. Bipolar (I and II) and bipolar I patients with suicide attempts were significantly higher in harm avoidance (HA) and reward dependence compared with patients without suicide attempts. Patients (I and II) with suicide attempts had significantly more anticipatory worry, fatigability and asthenia than patients without suicide attempts. Bipolar I patients with suicide attempts had significantly more fatigability and asthenia and were more dependent than patients without suicide attempts. HA was lowest in patients with no suicide attempts and no family history of suicide, higher in patients with family history of suicide or patients with suicide attempts, and significantly highest in patients with suicide attempts and family history of suicide. Patients with suicide attempts and family history of suicide had more anticipatory worry, fatigability and asthenia. Bipolar disorder was significantly correlated to HA and suicide attempts to HA and PS. Family history of suicide and gender were significantly correlated to suicide attempts.

    Conclusions: Age of onset, HA, PS, gender and family history of suicide had a moderate to very strong effect on suicide attempts in bipolar patients.

  • 9.
    Pezzoli, S.
    et al.
    Univ Sheffield, Dept Neurosci, Sheffield, S Yorkshire, England.;Kings Coll London, Dept Psychosis Studies, London, England..
    Emsell, L.
    Katholieke Univ Leuven, Dept Imaging & Pathol, Leuven, Belgium.;Natl Univ Ireland Galway, Neuroimaging Cognit & Genom Ctr NICOG, Galway, Ireland.;NCBES Galway Neurosci Ctr, Galway, Ireland.;Katholieke Univ Leuven, Dept Old Age Psychiat, Leuven, Belgium..
    Yip, S.
    Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA.;Kings Coll London, Ctr Neuroimaging Sci, London, England..
    Dima, D.
    Kings Coll London, Social Genet & Dev Psychiat Ctr, London, England.;Icahn Sch Med Mt Sinai, Dept Psychiat, New York, NY 10029 USA..
    Giannakopoulos, P.
    Univ Geneva, Dept Psychiat, Geneva, Switzerland..
    Zarei, M.
    Univ Geneva, Dept Psychiat, Geneva, Switzerland..
    Tognin, S.
    Kings Coll London, Dept Psychosis Studies, London, England..
    James, A.
    Univ Oxford, Dept Psychiat, Oxford, England..
    Haller, Sven
    Shahid Beheshti Univ, Natl Brain Mapping Ctr, Tehran, Iran.;Affidea CDRC Ctr Diagnost Radiol Carouge, Carouge, Switzerland.;Univ Geneva, Fac Med, Geneva, Switzerland.;Univ Hosp Freiburg, Dept Neuroradiol, Freiburg, Germany..
    Frangou, S.
    Icahn Sch Med Mt Sinai, Dept Psychiat, New York, NY 10029 USA..
    Goodwin, G.
    Univ Oxford, Dept Psychiat, Oxford, England..
    McDonald, C.
    Natl Univ Ireland Galway, Neuroimaging Cognit & Genom Ctr NICOG, Galway, Ireland.;NCBES Galway Neurosci Ctr, Galway, Ireland..
    Kempton, M.
    Kings Coll London, Dept Psychosis Studies, London, England..
    Meta-analysis of regional white matter volume in bipolar disorder with replication in an independent sample2016In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 18, p. 111-112Article in journal (Other academic)
  • 10.
    Päären, Aivar
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Bohman, Hannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    von Knorring, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Olsson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    von Knorring, Anne-Liis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Uppsala Univ, Inst Neurovetenskap Barn & Ungdomspsykiatri, Uppsala, Sweden..
    Jonsson, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Uppsala Univ, Inst Neurovetenskap Barn & Ungdomspsykiatri, Uppsala, Sweden..
    Early risk factors for adult bipolar disorder in adolescents with mood disorders: a 15-year follow-up of a community sample2017In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 19, no S1, p. 63-63Article in journal (Other academic)
  • 11.
    Song, Jie
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bergen, Sarah E
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Kuja-Halkola, Ralf
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Landén, Mikael
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bipolar disorder and its relation to major psychiatric disorders: a family-based study in the Swedish population2015In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 17, no 2, p. 184-193Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Bipolar disorder (BPD) shares genetic components with other psychiatric disorders; however, uncertainty remains about where in the psychiatric spectra BPD falls. To understand the etiology of BPD, we studied the familial aggregation of BPD and co-aggregation between BPD and schizophrenia, depression, anxiety disorders, attention-deficit hyperactivity disorder, drug abuse, personality disorders, and autism spectrum disorders.

    METHODS: A population-based cohort was created by linking several Swedish national registers. A total of 54,723 individuals with BPD were identified among 8,141,033 offspring from 4,149,748 nuclear families. The relative risk of BPD in relatives and the co-occurrence of other psychiatric disorders in patients with BPD and their relatives were compared to those of matched-population controls. Structural equation modeling was used to estimate the heritability and tetrachoric correlation.

    RESULTS: The familial risks for relatives of BPD probands were 5.8-7.9 in first-degree relatives, and decreased with genetic distance. Co-occurrence risks for other psychiatric disorders were 9.7-22.9 in individuals with BPD and 1.7-2.8 in full siblings of BPD probands. Heritability for BPD was estimated at 58%. The correlations between BPD and other psychiatric disorders were considerable (0.37-0.62) and primarily due to genetic effects. The correlation with depression was the highest (0.62), and was 0.44 for schizophrenia.

    CONCLUSIONS: The high familial risks provide evidence that genetic factors play an important role in the etiology of BPD, and the shared genetic determinants suggest pleiotropic effects across different psychiatric disorders. Results also indicate that BPD is in both the mood and psychotic spectra, but possibly more closely related to mood disorders.

  • 12. Welander-Vatn, Audun S
    et al.
    Jensen, Jimmy
    Institute of Psychiatry, University of Oslo & Department of Psychiatry, Ulleval University Hospital, Oslo.
    Lycke, Christine
    Agartz, Ingrid
    Server, Andres
    Gadmar, Øystein Bech
    Melle, Ingrid
    Nakstad, Per Hjalmar
    Andreassen, Ole A
    No altered dorsal anterior cingulate activation in bipolar II disorder patients during a Go/No-go task: an fMRI study.2009In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 11, no 3, p. 270-279Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: It has been reported that one of the core features in patients with bipolar disorder II (BD II) is increased impulsivity. The aim of this study was to investigate whether patients with BD II showed decreased activation in the dorsal anterior cingulate cortex (dACC) as compared to healthy controls when performing a task sensitive to impulsivity.

    METHODS: Twenty-seven BD II patients and 28 healthy controls performed a Go/No-go task during a functional magnetic resonance imaging (fMRI) session. Eleven of the patients were unmedicated, and possible group differences between medicated and unmedicated patients were also assessed. Results: The groups did not differ in behavioral performance on the Go/No-go task. Both BD II subjects and healthy controls demonstrated dACC activity during the task, and analyses revealed no statistically significant group differences. Medicated and unmedicated patients also did not differ in the degree of fMRI activation.

    CONCLUSIONS: These findings do not support the hypothesis of abnormal dACC activity during a Go/No-go task in BD II patients.

  • 13.
    Wingard, Louise
    et al.
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Taipale, Heidi
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland;Univ Eastern Finland, Sch Pharm, Kuopio, Finland.
    Reutfors, Johan
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Westerlund, Anna
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden.
    Tiihonen, Jari
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.
    Tanskanen, Antti
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.
    Andersen, Morten
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Pharmacoepidemiol CPE, Stockholm, Sweden;Univ Copenhagen, Dept Drug Design & Pharmacol, Fac Hlth & Med Sci, Copenhagen, Denmark;Univ Southern Denmark, Res Unit Gen Practice, Odense, Denmark.
    Initiation and long-term use of benzodiazepines and Z-drugs in bipolar disorder2018In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 20, no 7, p. 634-646Article in journal (Refereed)
    Abstract [en]

    Objectives

    Increasing evidence points to the harmful effects of long‐term benzodiazepine treatment. Our objective was to study the incidence of, and predictors for, long‐term use of benzodiazepines and Z‐drugs in bipolar disorder.

    Methods

    We conducted a population‐based cohort study, using data from Swedish national registers. Swedish residents aged 18‐75 years with a recorded diagnosis of bipolar disorder or mania between July 2006 and December 2012, and no history of benzodiazepine/Z‐drug use in the past year, were included. Patients were followed for 1 year with regard to prescription fills of benzodiazepines/Z‐drugs. Initiators were followed for another year during which continuous use for >6 months was defined as “long‐term”. Patient and prescription characteristics were investigated as potential predictors for long‐term use in multivariate logistic regression models.

    Results

    Out of the 21 883 patients included, 29% started benzodiazepine/Z‐drug treatment, of whom one in five became long‐term users. Patients who were prescribed clonazepam or alprazolam had high odds for subsequent long‐term use (adjusted odds ratios [aORs] 3.78 [95% confidence interval (CI) 2.24‐6.38] and 2.03 [95% CI 1.30‐3.18], respectively), compared to those prescribed diazepam. Polytherapy with benzodiazepines/Z‐drugs also predicted long‐term use (aOR 2.46, 95% CI 1.79‐3.38), as did age ≥60 years (aOR 1.93, 95% CI 1.46‐2.53, compared to age <30 years), and concomitant treatment with psychostimulants (aOR 1.78, 95% CI 1.33‐2.39).

    Conclusions

    The incidence of subsequent long‐term use among bipolar benzodiazepine initiators is high. Patients on clonazepam, alprazolam or benzodiazepine/Z‐drug polytherapy have the highest risk of becoming long‐term users, suggesting that these treatments should be used restrictively.

  • 14.
    Wingård, L.
    et al.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Brandt, L.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Bodén, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Kieler, H.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Andersen, M.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Reutfors, J.
    Karolinska Inst, Dept Med Solna, Stockholm, Sweden..
    Comparative risks of treatment failure in bipolar 1 disorder: a population based study of lithium, valproate, olanzapine, quetiapine and aripiprazole in post mania relapse prevention2017In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 19, no S1, p. 100-101Article in journal (Other academic)
  • 15. Winham, S.
    et al.
    Cuellar Barboza, A.
    Batzler, A.
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Alda, M.
    Andreassen, O.
    Di Florio, A.
    Forstner, A.
    Kelsoe, J.
    Landen, M.
    Vincent, J.
    McElroy, S.
    Frye, M.
    Biernacka, J.
    Genome-wide interactions with body mass index and bipolar disorder risk: a study from the psychiatric genomics consortium bipolar disorder working group2018In: Bipolar Disorders, ISSN 1398-5647, E-ISSN 1399-5618, Vol. 20, p. 110-111Article in journal (Other academic)
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