Serge Beaulieu, M.D., Ph.D., FRCPC
Contact
serge.beaulieu@mcgill.ca
6875 Boulevard LaSalle
Montréal, QC
H4H 1R3
Office:H-1157, Pavillon Newman
Office phone: (514) 761-6131 x3303
Fax: (514) 888-4062
Researcher, Douglas Research Centre
Medical Chief, Bipolar Disorders Program, Douglas Mental Health University Institute
Medical Chief, Mood, Anxiety and Impulsivity Disorders Program, Douglas Mental Health University Institute
Associate Professor, Department of Psychiatry, McGill University
Lab name: Programme des troubles bipolaires
Theme-Based Group: Stress, Anxiety, Depression, and SuicideDivision: Clinical Research
The Research Team of the Bipolar Disorders Program led by Serge Beaulieu, MD, PhD, FRCPC is interested in the biological and environmental factors of bipolar disorders. The aim of ongoing research projects is to identify these factors and to improve and develop better treatments for bipolar disorders. The main objective is to better understand bipolar disorders from the epidemiological, biological, chemical, psychological, social and genetic points of view. A dynamic interdisciplinary team who concentrates its efforts on carrying out various research projects, on knowledge transfer, and on providing clinical services within the Bipolar Disorders Program.
Dr Beaulieu was the recipient of the Douglas Utting Prize in 2004, which is awarded annually to one person in Canada who has contributed significantly to promoting awareness of depression and/or its research and treatment. He also, received the Teaching-Clinician Award from the Quebec Medical Association in 2009, which recognizes the exceptional contribution of a physician who also teaches at a faculty of medicine. Dr. Beaulieu is a Distinguished Fellow of the APA (American Psychiatric Association) and served as member of the Board of Councilors of the ISBD and was a member of the Scientific Council of the Canadian Psychiatric Association. He is a Board member of Revivre, a self-help community organization devoted to patients suffering from mood and anxiety disorders.
Recent Publications
2024
Greenway, Kyle T; Garel, Nicolas; Dinh-Williams, Lê-Anh L; Beaulieu, Serge; Turecki, Gustavo; Rej, Soham; Richard-Devantoy, Stephane
Music as an Intervention to Improve the Hemodynamic Response of Ketamine in Depression: A Randomized Clinical Trial Journal Article
In: JAMA Netw Open, vol. 7, no. 2, pp. e2354719, 2024, ISSN: 2574-3805.
@article{pmid38315489,
title = {Music as an Intervention to Improve the Hemodynamic Response of Ketamine in Depression: A Randomized Clinical Trial},
author = {Kyle T Greenway and Nicolas Garel and Lê-Anh L Dinh-Williams and Serge Beaulieu and Gustavo Turecki and Soham Rej and Stephane Richard-Devantoy},
doi = {10.1001/jamanetworkopen.2023.54719},
issn = {2574-3805},
year = {2024},
date = {2024-02-01},
journal = {JAMA Netw Open},
volume = {7},
number = {2},
pages = {e2354719},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2023
Yatham, Lakshmi N; Arumugham, Shyam Sundar; Kesavan, Muralidharan; Ramachandran, Kanchana; Murthy, Nithyananda S; Saraf, Gayatri; Ouyang, Yongdong; Bond, David J; Schaffer, Ayal; Ravindran, Arun; Ravindran, Nisha; Frey, Benicio N; Daigneault, Andrée; Beaulieu, Serge; Lam, Raymond W; Kondapuram, Nithin; Reddy, M S; Bhandary, R P; Ashok, Mysore V; Ha, Kyooseob; Ahn, Yong Min; Milev, Roumen; Wong, Hubert; and, Y C Janardhan Reddy
Duration of Adjunctive Antidepressant Maintenance in Bipolar I Depression Journal Article
In: N Engl J Med, vol. 389, no. 5, pp. 430–440, 2023, ISSN: 1533-4406.
@article{pmid37530824,
title = {Duration of Adjunctive Antidepressant Maintenance in Bipolar I Depression},
author = {Lakshmi N Yatham and Shyam Sundar Arumugham and Muralidharan Kesavan and Kanchana Ramachandran and Nithyananda S Murthy and Gayatri Saraf and Yongdong Ouyang and David J Bond and Ayal Schaffer and Arun Ravindran and Nisha Ravindran and Benicio N Frey and Andrée Daigneault and Serge Beaulieu and Raymond W Lam and Nithin Kondapuram and M S Reddy and R P Bhandary and Mysore V Ashok and Kyooseob Ha and Yong Min Ahn and Roumen Milev and Hubert Wong and Y C Janardhan Reddy and },
doi = {10.1056/NEJMoa2300184},
issn = {1533-4406},
year = {2023},
date = {2023-08-01},
journal = {N Engl J Med},
volume = {389},
number = {5},
pages = {430--440},
abstract = {BACKGROUND: Antidepressants are used to treat acute depression in patients with bipolar I disorder, but their effect as maintenance treatment after the remission of depression has not been well studied.nnMETHODS: We conducted a multisite, double-blind, randomized, placebo-controlled trial of maintenance of treatment with adjunctive escitalopram or bupropion XL as compared with discontinuation of antidepressant therapy in patients with bipolar I disorder who had recently had remission of a depressive episode. Patients were randomly assigned in a 1:1 ratio to continue treatment with antidepressants for 52 weeks after remission or to switch to placebo at 8 weeks. The primary outcome, assessed in a time-to-event analysis, was any mood episode, as defined by scores on scales measuring symptoms of hypomania or mania, depression, suicidality, and mood-episode severity; additional treatment or hospitalization for mood symptoms; or attempted or completed suicide. Key secondary outcomes included the time to an episode of mania or hypomania or depression.nnRESULTS: Of 209 patients with bipolar I disorder who participated in an open-label treatment phase, 150 who had remission of depression were enrolled in the double-blind phase in addition to 27 patients who were enrolled directly. A total of 90 patients were assigned to continue treatment with the prescribed antidepressant for 52 weeks (52-week group) and 87 were assigned to switch to placebo at 8 weeks (8-week group). The trial was stopped before full recruitment was reached owing to slow recruitment and funding limitations. At 52 weeks, 28 of the patients in the 52-week group (31%) and 40 in the 8-week group (46%) had a primary-outcome event. The hazard ratio for time to any mood episode in the 52-week group relative to the 8-week group was 0.68 (95% confidence interval [CI], 0.43 to 1.10; P = 0.12 by log-rank test). A total of 11 patients in the 52-week group (12%) as compared with 5 patients in the 8-week group (6%) had mania or hypomania (hazard ratio, 2.28; 95% CI, 0.86 to 6.08), and 15 patients (17%) as compared with 35 patients (40%) had recurrence of depression (hazard ratio, 0.43; 95% CI, 0.25 to 0.75). The incidence of adverse events was similar in the two groups.nnCONCLUSIONS: In a trial involving patients with bipolar I disorder and a recently remitted depressive episode, adjunctive treatment with escitalopram or bupropion XL that continued for 52 weeks did not show a significant benefit as compared with treatment for 8 weeks in preventing relapse of any mood episode. The trial was stopped early owing to slow recruitment and funding limitations. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00958633.).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Antidepressants are used to treat acute depression in patients with bipolar I disorder, but their effect as maintenance treatment after the remission of depression has not been well studied.nnMETHODS: We conducted a multisite, double-blind, randomized, placebo-controlled trial of maintenance of treatment with adjunctive escitalopram or bupropion XL as compared with discontinuation of antidepressant therapy in patients with bipolar I disorder who had recently had remission of a depressive episode. Patients were randomly assigned in a 1:1 ratio to continue treatment with antidepressants for 52 weeks after remission or to switch to placebo at 8 weeks. The primary outcome, assessed in a time-to-event analysis, was any mood episode, as defined by scores on scales measuring symptoms of hypomania or mania, depression, suicidality, and mood-episode severity; additional treatment or hospitalization for mood symptoms; or attempted or completed suicide. Key secondary outcomes included the time to an episode of mania or hypomania or depression.nnRESULTS: Of 209 patients with bipolar I disorder who participated in an open-label treatment phase, 150 who had remission of depression were enrolled in the double-blind phase in addition to 27 patients who were enrolled directly. A total of 90 patients were assigned to continue treatment with the prescribed antidepressant for 52 weeks (52-week group) and 87 were assigned to switch to placebo at 8 weeks (8-week group). The trial was stopped before full recruitment was reached owing to slow recruitment and funding limitations. At 52 weeks, 28 of the patients in the 52-week group (31%) and 40 in the 8-week group (46%) had a primary-outcome event. The hazard ratio for time to any mood episode in the 52-week group relative to the 8-week group was 0.68 (95% confidence interval [CI], 0.43 to 1.10; P = 0.12 by log-rank test). A total of 11 patients in the 52-week group (12%) as compared with 5 patients in the 8-week group (6%) had mania or hypomania (hazard ratio, 2.28; 95% CI, 0.86 to 6.08), and 15 patients (17%) as compared with 35 patients (40%) had recurrence of depression (hazard ratio, 0.43; 95% CI, 0.25 to 0.75). The incidence of adverse events was similar in the two groups.nnCONCLUSIONS: In a trial involving patients with bipolar I disorder and a recently remitted depressive episode, adjunctive treatment with escitalopram or bupropion XL that continued for 52 weeks did not show a significant benefit as compared with treatment for 8 weeks in preventing relapse of any mood episode. The trial was stopped early owing to slow recruitment and funding limitations. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT00958633.).
Tourjman, Smadar V; Buck, Gabriella; Jutras-Aswad, Didier; Khullar, Atul; McInerney, Shane; Saraf, Gayatri; Pinto, Jairo V; Potvin, Stephane; Poulin, Marie-Josée; Frey, Benicio N; Kennedy, Sidney H; Lam, Raymond W; MacQueen, Glenda; Milev, Roumen; Parikh, Sagar V; Ravindran, Arun; McIntyre, Roger S; Schaffer, Ayal; Taylor, Valerie H; van Ameringen, Michael; Yatham, Lakshmi N; Beaulieu, Serge
In: Can J Psychiatry, vol. 68, no. 5, pp. 299–311, 2023, ISSN: 1497-0015.
@article{pmid35711159,
title = {Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: A Systematic Review and Recommendations of Cannabis use in Bipolar Disorder and Major Depressive Disorder},
author = {Smadar V Tourjman and Gabriella Buck and Didier Jutras-Aswad and Atul Khullar and Shane McInerney and Gayatri Saraf and Jairo V Pinto and Stephane Potvin and Marie-Josée Poulin and Benicio N Frey and Sidney H Kennedy and Raymond W Lam and Glenda MacQueen and Roumen Milev and Sagar V Parikh and Arun Ravindran and Roger S McIntyre and Ayal Schaffer and Valerie H Taylor and Michael van Ameringen and Lakshmi N Yatham and Serge Beaulieu},
doi = {10.1177/07067437221099769},
issn = {1497-0015},
year = {2023},
date = {2023-05-01},
journal = {Can J Psychiatry},
volume = {68},
number = {5},
pages = {299--311},
abstract = {BACKGROUND: Given the increasing acceptability and legalization of cannabis in some jurisdictions, clinicians need to improve their understanding of the effect of cannabis use on mood disorders.nnOBJECTIVE: The purpose of this task force report is to examine the association between cannabis use and incidence, presentation, course and treatment of bipolar disorder and major depressive disorder, and the treatment of comorbid cannabis use disorder.nnMETHODS: We conducted a systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials from inception to October 2020 focusing on cannabis use and bipolar disorder or major depressive disorder, and treatment of comorbid cannabis use disorder. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to evaluate the quality of evidence and clinical considerations were integrated to generate Canadian Network for Mood and Anxiety Treatments recommendations.nnRESULTS: Of 12,691 publications, 56 met the criteria: 23 on bipolar disorder, 21 on major depressive disorder, 11 on both diagnoses and 1 on treatment of comorbid cannabis use disorder and major depressive disorder. Of 2,479,640 participants, 12,502 were comparison participants, 73,891 had bipolar disorder and 408,223 major depressive disorder without cannabis use. Of those with cannabis use, 2,761 had bipolar disorder and 5,044 major depressive disorder. The lifetime prevalence of cannabis use was 52%-71% and 6%-50% in bipolar disorder and major depressive disorder, respectively. Cannabis use was associated with worsening course and symptoms of both mood disorders, with more consistent associations in bipolar disorder than major depressive disorder: increased severity of depressive, manic and psychotic symptoms in bipolar disorder and depressive symptoms in major depressive disorder. Cannabis use was associated with increased suicidality and decreased functioning in both bipolar disorder and major depressive disorder. Treatment of comorbid cannabis use disorder and major depressive disorder did not show significant results.nnCONCLUSION: The data indicate that cannabis use is associated with worsened course and functioning of bipolar disorder and major depressive disorder. Future studies should include more accurate determinations of type, amount and frequency of cannabis use and select comparison groups which allow to control for underlying common factors.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Given the increasing acceptability and legalization of cannabis in some jurisdictions, clinicians need to improve their understanding of the effect of cannabis use on mood disorders.nnOBJECTIVE: The purpose of this task force report is to examine the association between cannabis use and incidence, presentation, course and treatment of bipolar disorder and major depressive disorder, and the treatment of comorbid cannabis use disorder.nnMETHODS: We conducted a systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials from inception to October 2020 focusing on cannabis use and bipolar disorder or major depressive disorder, and treatment of comorbid cannabis use disorder. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to evaluate the quality of evidence and clinical considerations were integrated to generate Canadian Network for Mood and Anxiety Treatments recommendations.nnRESULTS: Of 12,691 publications, 56 met the criteria: 23 on bipolar disorder, 21 on major depressive disorder, 11 on both diagnoses and 1 on treatment of comorbid cannabis use disorder and major depressive disorder. Of 2,479,640 participants, 12,502 were comparison participants, 73,891 had bipolar disorder and 408,223 major depressive disorder without cannabis use. Of those with cannabis use, 2,761 had bipolar disorder and 5,044 major depressive disorder. The lifetime prevalence of cannabis use was 52%-71% and 6%-50% in bipolar disorder and major depressive disorder, respectively. Cannabis use was associated with worsening course and symptoms of both mood disorders, with more consistent associations in bipolar disorder than major depressive disorder: increased severity of depressive, manic and psychotic symptoms in bipolar disorder and depressive symptoms in major depressive disorder. Cannabis use was associated with increased suicidality and decreased functioning in both bipolar disorder and major depressive disorder. Treatment of comorbid cannabis use disorder and major depressive disorder did not show significant results.nnCONCLUSION: The data indicate that cannabis use is associated with worsened course and functioning of bipolar disorder and major depressive disorder. Future studies should include more accurate determinations of type, amount and frequency of cannabis use and select comparison groups which allow to control for underlying common factors.
Kondo, Fumika; Whitehead, Jocelyne C; Corbalán, Fernando; Beaulieu, Serge; Armony, Jorge L
Emotion regulation in bipolar disorder type-I: multivariate analysis of fMRI data Journal Article
In: Int J Bipolar Disord, vol. 11, no. 1, pp. 12, 2023, ISSN: 2194-7511.
@article{pmid36964848,
title = {Emotion regulation in bipolar disorder type-I: multivariate analysis of fMRI data},
author = {Fumika Kondo and Jocelyne C Whitehead and Fernando Corbalán and Serge Beaulieu and Jorge L Armony},
doi = {10.1186/s40345-023-00292-w},
issn = {2194-7511},
year = {2023},
date = {2023-03-01},
journal = {Int J Bipolar Disord},
volume = {11},
number = {1},
pages = {12},
abstract = {BACKGROUND: Bipolar disorder type-I (BD-I) patients are known to show emotion regulation abnormalities. In a previous fMRI study using an explicit emotion regulation paradigm, we compared responses from 19 BD-I patients and 17 matched healthy controls (HC). A standard general linear model-based univariate analysis revealed that BD patients showed increased activations in inferior frontal gyrus when instructed to decrease their emotional response as elicited by neutral images. We implemented multivariate pattern recognition analyses on the same data to examine if we could classify conditions within-group as well as HC versus BD.nnMETHODS: We reanalyzed explicit emotion regulation data using a multivariate pattern recognition approach, as implemented in PRONTO software. The original experimental paradigm consisted of a full 2 × 2 factorial design, with valence (Negative/Neutral) and instruction (Look/Decrease) as within subject factors.nnRESULTS: The multivariate models were able to accurately classify different task conditions when HC and BD were analyzed separately (63.24%-75.00%, p = 0.001-0.012). In addition, the models were able to correctly classify HC versus BD with significant accuracy in conditions where subjects were instructed to downregulate their felt emotion (59.60%-60.84%, p = 0.014-0.018). The results for HC versus BD classification demonstrated contributions from the salience network, several occipital and frontal regions, inferior parietal lobes, as well as other cortical regions, to achieve above-chance classifications.nnCONCLUSIONS: Our multivariate analysis successfully reproduced some of the main results obtained in the previous univariate analysis, confirming that these findings are not dependent on the analysis approach. In particular, both types of analyses suggest that there is a significant difference of neural patterns between conditions within each subject group. The multivariate approach also revealed that reappraisal conditions provide the most informative activity for differentiating HC versus BD, irrespective of emotional valence (negative or neutral). The current results illustrate the importance of investigating the cognitive control of emotion in BD. We also propose a set of candidate regions for further study of emotional control in BD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Bipolar disorder type-I (BD-I) patients are known to show emotion regulation abnormalities. In a previous fMRI study using an explicit emotion regulation paradigm, we compared responses from 19 BD-I patients and 17 matched healthy controls (HC). A standard general linear model-based univariate analysis revealed that BD patients showed increased activations in inferior frontal gyrus when instructed to decrease their emotional response as elicited by neutral images. We implemented multivariate pattern recognition analyses on the same data to examine if we could classify conditions within-group as well as HC versus BD.nnMETHODS: We reanalyzed explicit emotion regulation data using a multivariate pattern recognition approach, as implemented in PRONTO software. The original experimental paradigm consisted of a full 2 × 2 factorial design, with valence (Negative/Neutral) and instruction (Look/Decrease) as within subject factors.nnRESULTS: The multivariate models were able to accurately classify different task conditions when HC and BD were analyzed separately (63.24%-75.00%, p = 0.001-0.012). In addition, the models were able to correctly classify HC versus BD with significant accuracy in conditions where subjects were instructed to downregulate their felt emotion (59.60%-60.84%, p = 0.014-0.018). The results for HC versus BD classification demonstrated contributions from the salience network, several occipital and frontal regions, inferior parietal lobes, as well as other cortical regions, to achieve above-chance classifications.nnCONCLUSIONS: Our multivariate analysis successfully reproduced some of the main results obtained in the previous univariate analysis, confirming that these findings are not dependent on the analysis approach. In particular, both types of analyses suggest that there is a significant difference of neural patterns between conditions within each subject group. The multivariate approach also revealed that reappraisal conditions provide the most informative activity for differentiating HC versus BD, irrespective of emotional valence (negative or neutral). The current results illustrate the importance of investigating the cognitive control of emotion in BD. We also propose a set of candidate regions for further study of emotional control in BD.
2022
Soh, Jocelyn Fotso; Bodenstein, Katie; Yu, Oriana Hoi Yun; Linnaranta, Outi; Renaud, Suzane; Mahdanian, Artin; Su, Chien-Lin; Mucsi, Istvan; Mulsant, Benoit; Herrmann, Nathan; Rajji, Tarek; Beaulieu, Serge; Sekhon, Harmehr; Rej, Soham
Atorvastatin lowers serum calcium levels in lithium-users: results from a randomized controlled trial Journal Article
In: BMC Endocr Disord, vol. 22, no. 1, pp. 238, 2022, ISSN: 1472-6823.
@article{pmid36153583,
title = {Atorvastatin lowers serum calcium levels in lithium-users: results from a randomized controlled trial},
author = {Jocelyn Fotso Soh and Katie Bodenstein and Oriana Hoi Yun Yu and Outi Linnaranta and Suzane Renaud and Artin Mahdanian and Chien-Lin Su and Istvan Mucsi and Benoit Mulsant and Nathan Herrmann and Tarek Rajji and Serge Beaulieu and Harmehr Sekhon and Soham Rej},
doi = {10.1186/s12902-022-01145-w},
issn = {1472-6823},
year = {2022},
date = {2022-09-01},
journal = {BMC Endocr Disord},
volume = {22},
number = {1},
pages = {238},
abstract = {BACKGROUND: Although lithium is considered the gold-standard treatment for bipolar disorder (BD), it is associated with a variety of major endocrine and metabolic side effects, including parathyroid hormone (PTH) dependent hypercalcemia. Aside from surgery and medication discontinuation, there are limited treatments for hypercalcemia. This paper will assess data from a randomized controlled trial (RCT).nnMETHODS: This is a secondary analysis of an RCT that explored the effects of atorvastatin (n = 27) versus placebo (n = 33) on lithium-induced nephrogenic diabetes insipidus (NDI) in patients with BD and major depressive disorder (MDD) using lithium (n = 60), over a 12-week period. This secondary analysis will explore serum calcium levels and thyroid stimulating hormone (TSH) measured at baseline, week 4, and week 12.nnRESULTS: At 12-weeks follow-up while adjusting results for baseline, linear regression analyses found that corrected serum calcium levels were significantly lower in the treatment group (mean (M) = 2.30 mmol/L, standard deviation (SD) = 0.07) compared to the placebo group (M = 2.33 mmol/L, SD = 0.07) (β = - 0.03 (95% C.I.; - 0.0662, - 0.0035), p = 0.03) for lithium users. There were no significant changes in TSH.nnCONCLUSION: In lithium users with relatively normal calcium levels, receiving atorvastatin was associated with a decrease in serum calcium levels. Although exciting, this is a preliminary finding that needs further investigation with hypercalcemic patients. Future RCTs could examine whether atorvastatin can treat PTH dependent hypercalcemia due to lithium and other causes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Although lithium is considered the gold-standard treatment for bipolar disorder (BD), it is associated with a variety of major endocrine and metabolic side effects, including parathyroid hormone (PTH) dependent hypercalcemia. Aside from surgery and medication discontinuation, there are limited treatments for hypercalcemia. This paper will assess data from a randomized controlled trial (RCT).nnMETHODS: This is a secondary analysis of an RCT that explored the effects of atorvastatin (n = 27) versus placebo (n = 33) on lithium-induced nephrogenic diabetes insipidus (NDI) in patients with BD and major depressive disorder (MDD) using lithium (n = 60), over a 12-week period. This secondary analysis will explore serum calcium levels and thyroid stimulating hormone (TSH) measured at baseline, week 4, and week 12.nnRESULTS: At 12-weeks follow-up while adjusting results for baseline, linear regression analyses found that corrected serum calcium levels were significantly lower in the treatment group (mean (M) = 2.30 mmol/L, standard deviation (SD) = 0.07) compared to the placebo group (M = 2.33 mmol/L, SD = 0.07) (β = - 0.03 (95% C.I.; - 0.0662, - 0.0035), p = 0.03) for lithium users. There were no significant changes in TSH.nnCONCLUSION: In lithium users with relatively normal calcium levels, receiving atorvastatin was associated with a decrease in serum calcium levels. Although exciting, this is a preliminary finding that needs further investigation with hypercalcemic patients. Future RCTs could examine whether atorvastatin can treat PTH dependent hypercalcemia due to lithium and other causes.
Moon, Eunsoo; Partonen, Timo; Beaulieu, Serge; Linnaranta, Outi
In: Neuropsychopharmacology, vol. 47, no. 8, pp. 1523–1536, 2022, ISSN: 1740-634X.
@article{pmid35115662,
title = {Melatonergic agents influence the sleep-wake and circadian rhythms in healthy and psychiatric participants: a systematic review and meta-analysis of randomized controlled trials},
author = {Eunsoo Moon and Timo Partonen and Serge Beaulieu and Outi Linnaranta},
doi = {10.1038/s41386-022-01278-5},
issn = {1740-634X},
year = {2022},
date = {2022-07-01},
journal = {Neuropsychopharmacology},
volume = {47},
number = {8},
pages = {1523--1536},
abstract = {Exogenous melatonergic agents are widely used to treat insomnia and sleep disturbance. Several studies have shown that they might also modulate circadian rhythms. The purpose of this systematic review and meta-analysis was to summarize current knowledge about the effects of melatonin supplements and melatonin agonists on the sleep-wake cycle as well as on the circadian rhythm of melatonin in healthy participants and in patients with psychiatric disorders. The following electronic databases were searched: EMBASE, PubMed, Web of Science, CINAHL, and Cochrane Library. Of the 12,719 articles, we finally selected 30 studies including 1294 healthy participants and 8 studies including 687 patients with psychiatric disorders. Cochrane risk of bias tool was used to assess the risk of bias. Using meta-ANOVA, studies on healthy participants showed advancing effects of melatonergic supplements and agonists on sleep-wake cycle according to dosing time and dosage, despite the fact that the original individual melatonin rhythm was within a normal range (fixed effect model standardized mean difference [95% Confidence Interval] = -0.639[-0.968 to -0.310]). In a limited number of randomized controlled trials with psychiatric patients, the findings seemed similar to those with healthy participants, despite the psychiatric disorders and treatment related factors affecting circadian rhythms. Given the unmet clinical need for evidence-based treatments to correct circadian rhythms in psychiatric disorders, efficacy of melatonergic agents seen in healthy participants, and similarity of findings among psychiatric patients, large scale, well-designed randomized controlled trials are needed to test efficacy on circadian parameters in psychiatric disorders.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Exogenous melatonergic agents are widely used to treat insomnia and sleep disturbance. Several studies have shown that they might also modulate circadian rhythms. The purpose of this systematic review and meta-analysis was to summarize current knowledge about the effects of melatonin supplements and melatonin agonists on the sleep-wake cycle as well as on the circadian rhythm of melatonin in healthy participants and in patients with psychiatric disorders. The following electronic databases were searched: EMBASE, PubMed, Web of Science, CINAHL, and Cochrane Library. Of the 12,719 articles, we finally selected 30 studies including 1294 healthy participants and 8 studies including 687 patients with psychiatric disorders. Cochrane risk of bias tool was used to assess the risk of bias. Using meta-ANOVA, studies on healthy participants showed advancing effects of melatonergic supplements and agonists on sleep-wake cycle according to dosing time and dosage, despite the fact that the original individual melatonin rhythm was within a normal range (fixed effect model standardized mean difference [95% Confidence Interval] = -0.639[-0.968 to -0.310]). In a limited number of randomized controlled trials with psychiatric patients, the findings seemed similar to those with healthy participants, despite the psychiatric disorders and treatment related factors affecting circadian rhythms. Given the unmet clinical need for evidence-based treatments to correct circadian rhythms in psychiatric disorders, efficacy of melatonergic agents seen in healthy participants, and similarity of findings among psychiatric patients, large scale, well-designed randomized controlled trials are needed to test efficacy on circadian parameters in psychiatric disorders.
2021
Prillo, Jake; Soh, Jocelyn Fotso; Park, Haley; Beaulieu, Serge; Linnaranta, Outi; Rej, Soham
Obesity and metabolic comorbidity in bipolar disorder: do patients on lithium comprise a subgroup? A naturalistic study Journal Article
In: BMC Psychiatry, vol. 21, no. 1, pp. 558, 2021, ISSN: 1471-244X.
@article{pmid34758769,
title = {Obesity and metabolic comorbidity in bipolar disorder: do patients on lithium comprise a subgroup? A naturalistic study},
author = {Jake Prillo and Jocelyn Fotso Soh and Haley Park and Serge Beaulieu and Outi Linnaranta and Soham Rej},
doi = {10.1186/s12888-021-03572-w},
issn = {1471-244X},
year = {2021},
date = {2021-11-01},
journal = {BMC Psychiatry},
volume = {21},
number = {1},
pages = {558},
abstract = {BACKGROUND: Bipolar disorders (BD) are associated with increased prevalence of obesity and metabolic syndrome (MetS). Nevertheless, there is a wide range in prevalence estimates, with little known about the contributions of pharmacotherapy. It has been suggested that lithium might have a more favorable metabolic profile. We hypothesized that lithium use is associated with less increased body mass index (BMI), MetS, and type II diabetes, when compared with non-lithium users (those on anticonvulsants, second-generation antipsychotics).nnMETHODS: Cross-sectional study of 129 patients aged 18-85 with bipolar disorder, followed at tertiary care clinics in Montreal. Patients using lithium were compared with those not on lithium, for body mass index and metabolic syndrome.nnRESULTS: The prevalence of obesity and metabolic syndrome in the sample of lithium-using patients with BD was 42.4 and 35.7% respectively, with an average BMI of 29.10 (+/- 6.70). Lithium and non-lithium groups did not differ in BMI or prevalence of MetS. However, compared to the non-lithium group, lithium users had lower hemoglobin A1C (5.24 +/- 0.53 versus 6.01 +/- 1.83, U = 753.5, p = 0.006) and lower triglycerides (1.46 +/- 0.88 versus 2.01 +/- 1.25, U = 947, p = 0.020).nnCONCLUSIONS: There is a high prevalence of obesity and metabolic syndrome among patients with bipolar disorder. However, this did not appear to be associated with lithium use, when compared to those not on lithium. The lithium subgroup was also associated with lower prevalence of type II diabetes. Future prospective and intervention studies with larger sample sizes are necessary to further explore the association between lithium and insulin resistance, as well as its underlying mechanisms.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Bipolar disorders (BD) are associated with increased prevalence of obesity and metabolic syndrome (MetS). Nevertheless, there is a wide range in prevalence estimates, with little known about the contributions of pharmacotherapy. It has been suggested that lithium might have a more favorable metabolic profile. We hypothesized that lithium use is associated with less increased body mass index (BMI), MetS, and type II diabetes, when compared with non-lithium users (those on anticonvulsants, second-generation antipsychotics).nnMETHODS: Cross-sectional study of 129 patients aged 18-85 with bipolar disorder, followed at tertiary care clinics in Montreal. Patients using lithium were compared with those not on lithium, for body mass index and metabolic syndrome.nnRESULTS: The prevalence of obesity and metabolic syndrome in the sample of lithium-using patients with BD was 42.4 and 35.7% respectively, with an average BMI of 29.10 (+/- 6.70). Lithium and non-lithium groups did not differ in BMI or prevalence of MetS. However, compared to the non-lithium group, lithium users had lower hemoglobin A1C (5.24 +/- 0.53 versus 6.01 +/- 1.83, U = 753.5, p = 0.006) and lower triglycerides (1.46 +/- 0.88 versus 2.01 +/- 1.25, U = 947, p = 0.020).nnCONCLUSIONS: There is a high prevalence of obesity and metabolic syndrome among patients with bipolar disorder. However, this did not appear to be associated with lithium use, when compared to those not on lithium. The lithium subgroup was also associated with lower prevalence of type II diabetes. Future prospective and intervention studies with larger sample sizes are necessary to further explore the association between lithium and insulin resistance, as well as its underlying mechanisms.
Seon, Quinta; Hum, Stanley; Tuineag, Maria; Pavlova, Barbara; Beaulieu, Serge; Linnaranta, Outi
Properties of common anxiety scales among patients with bipolar disorder Journal Article
In: J Affect Disord, vol. 281, pp. 972–979, 2021, ISSN: 1573-2517.
@article{pmid33229021,
title = {Properties of common anxiety scales among patients with bipolar disorder},
author = {Quinta Seon and Stanley Hum and Maria Tuineag and Barbara Pavlova and Serge Beaulieu and Outi Linnaranta},
doi = {10.1016/j.jad.2020.09.139},
issn = {1573-2517},
year = {2021},
date = {2021-02-01},
journal = {J Affect Disord},
volume = {281},
pages = {972--979},
abstract = {OBJECTIVES: Almost half of the patients with a bipolar disorder (BD) have anxiety disorder(s) (AD) during their lifetime, but feasible measures for all AD are few. Furthermore, cognitive impairments can compromise reliability of existing scales, since many are needed for full coverage. Thus, we investigated how reliably patients responded to anxiety scales and any symptom overlap to propose future improvements to anxiety assessments.nnMETHODS: We collected 152 observations in patients with BD with the Clinically Useful Anxiety Outcome Scale, Social Phobia Inventory, Panic Disorder Severity Measurement, and Trauma Screening Questionnaire (in total, 57 items). The scales were analyzed as a set in a Rasch model.nnRESULTS: During our analyses, we found indication that BD outpatients had difficulty differentiating response options to 70% (40/57) of items which were rescored or deleted. Only one case was misfitting (-2.65±.41). In total, 22 items were locally dependent and one indicated misfit. The final model included 25-items and fit the Rasch model (χ=35.92, DF=50, p=.93). The model was unidimensional, without losing appropriate associations with depression (r = 0.62), suicidality (r = 0.37), and hypomania (r= -0.01).nnLIMITATIONS: Bolstering the size of less frequent subgroups should be accomplished in future work.nnCONCLUSION: A unidimensional rather than categorical approach to severity of anxiety might be both useful and feasible in this population. Further development of screens is necessary to enable systematic screening and measurement of anxiety in BD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Almost half of the patients with a bipolar disorder (BD) have anxiety disorder(s) (AD) during their lifetime, but feasible measures for all AD are few. Furthermore, cognitive impairments can compromise reliability of existing scales, since many are needed for full coverage. Thus, we investigated how reliably patients responded to anxiety scales and any symptom overlap to propose future improvements to anxiety assessments.nnMETHODS: We collected 152 observations in patients with BD with the Clinically Useful Anxiety Outcome Scale, Social Phobia Inventory, Panic Disorder Severity Measurement, and Trauma Screening Questionnaire (in total, 57 items). The scales were analyzed as a set in a Rasch model.nnRESULTS: During our analyses, we found indication that BD outpatients had difficulty differentiating response options to 70% (40/57) of items which were rescored or deleted. Only one case was misfitting (-2.65±.41). In total, 22 items were locally dependent and one indicated misfit. The final model included 25-items and fit the Rasch model (χ=35.92, DF=50, p=.93). The model was unidimensional, without losing appropriate associations with depression (r = 0.62), suicidality (r = 0.37), and hypomania (r= -0.01).nnLIMITATIONS: Bolstering the size of less frequent subgroups should be accomplished in future work.nnCONCLUSION: A unidimensional rather than categorical approach to severity of anxiety might be both useful and feasible in this population. Further development of screens is necessary to enable systematic screening and measurement of anxiety in BD.
Soh, Jocelyn Fotso; Beaulieu, Serge; Trepiccione, Francesco; Linnaranta, Outi; Torres-Platas, Gabriela; Platt, Robert W; Renaud, Suzane; Su, Chien-Lin; Mucsi, Istvan; D'Apolito, Luciano; Mulsant, Benoit H; Levinson, Andrea; Saury, Sybille; Müller, Daniel; Schaffer, Ayal; Dols, Annemiek; Low, Nancy; Cervantes, Pablo; Christensen, Birgitte M; Herrmann, Nathan; Rajji, Tarek; Rej, Soham
A double-blind, randomized, placebo-controlled pilot trial of atorvastatin for nephrogenic diabetes insipidus in lithium users Journal Article
In: Bipolar Disord, vol. 23, no. 1, pp. 66–75, 2021, ISSN: 1399-5618.
@article{pmid32621644,
title = {A double-blind, randomized, placebo-controlled pilot trial of atorvastatin for nephrogenic diabetes insipidus in lithium users},
author = {Jocelyn Fotso Soh and Serge Beaulieu and Francesco Trepiccione and Outi Linnaranta and Gabriela Torres-Platas and Robert W Platt and Suzane Renaud and Chien-Lin Su and Istvan Mucsi and Luciano D'Apolito and Benoit H Mulsant and Andrea Levinson and Sybille Saury and Daniel Müller and Ayal Schaffer and Annemiek Dols and Nancy Low and Pablo Cervantes and Birgitte M Christensen and Nathan Herrmann and Tarek Rajji and Soham Rej},
doi = {10.1111/bdi.12973},
issn = {1399-5618},
year = {2021},
date = {2021-02-01},
journal = {Bipolar Disord},
volume = {23},
number = {1},
pages = {66--75},
abstract = {OBJECTIVE: Lithium remains an important treatment for mood disorders but is associated with kidney disease. Nephrogenic diabetes insipidus (NDI) is associated with up to 3-fold risk of incident chronic kidney disease among lithium users. There are limited randomized controlled trials (RCT) for treatments of lithium-induced NDI, and existing therapies can be poorly tolerated. Therefore, novel treatments are needed for lithium-induced NDI.nnMETHOD: We conducted a 12-week double-blind pilot RCT to assess the feasibility and efficacy of 20 mg/d atorvastatin vs placebo in the treatment of NDI in chronic lithium users. Patients, recruited between September 2017 and October 2018, were aged 18 to 85, currently on a stable dose of lithium, and determined to have NDI.nnRESULTS: Urinary osmolality (UOsm) at 12 weeks adjusted for baseline was not statistically different between groups (+39.6 mOsm/kg [95% CI, -35.3, 114.5] in atorvastatin compared to placebo groups). Secondary outcomes of fluid intake and aquaporin-2 excretions at 12 weeks adjusted for baseline were -0.13 L [95% CI, -0.54, 0.28] and 98.68 [95% CI, -190.34, 387.70], respectively. A moderate effect size was observed for improvements in baseline UOsm by ≥100 mOsm/kg at 12 weeks in patients who received atorvastatin compared to placebo (38.45% (10/26) vs 22.58% (7/31); Cohen's d = 0.66).nnCONCLUSION: Among lithium users with NDI, atorvastatin 20 mg/d did not significantly improve urinary osmolality compared to placebo over a 12-week period. Larger confirmatory trials with longer follow-up periods may help to further assess the effects of statins on NDI, especially within patients with more severe NDI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Lithium remains an important treatment for mood disorders but is associated with kidney disease. Nephrogenic diabetes insipidus (NDI) is associated with up to 3-fold risk of incident chronic kidney disease among lithium users. There are limited randomized controlled trials (RCT) for treatments of lithium-induced NDI, and existing therapies can be poorly tolerated. Therefore, novel treatments are needed for lithium-induced NDI.nnMETHOD: We conducted a 12-week double-blind pilot RCT to assess the feasibility and efficacy of 20 mg/d atorvastatin vs placebo in the treatment of NDI in chronic lithium users. Patients, recruited between September 2017 and October 2018, were aged 18 to 85, currently on a stable dose of lithium, and determined to have NDI.nnRESULTS: Urinary osmolality (UOsm) at 12 weeks adjusted for baseline was not statistically different between groups (+39.6 mOsm/kg [95% CI, -35.3, 114.5] in atorvastatin compared to placebo groups). Secondary outcomes of fluid intake and aquaporin-2 excretions at 12 weeks adjusted for baseline were -0.13 L [95% CI, -0.54, 0.28] and 98.68 [95% CI, -190.34, 387.70], respectively. A moderate effect size was observed for improvements in baseline UOsm by ≥100 mOsm/kg at 12 weeks in patients who received atorvastatin compared to placebo (38.45% (10/26) vs 22.58% (7/31); Cohen's d = 0.66).nnCONCLUSION: Among lithium users with NDI, atorvastatin 20 mg/d did not significantly improve urinary osmolality compared to placebo over a 12-week period. Larger confirmatory trials with longer follow-up periods may help to further assess the effects of statins on NDI, especially within patients with more severe NDI.
Buyukkurt, Asli; Bourguignon, Clément; Antinora, Christina; Farquhar, Elisabeth; Gao, Xiaoya; Passarella, Eloise; Sibthorpe, Duncan; Gou, Karine; Saury, Sybille; Beaulieu, Serge; Storch, Kai-Florian; Linnaranta, Outi
Irregular eating patterns associate with hypomanic symptoms in bipolar disorders Journal Article
In: Nutr Neurosci, vol. 24, no. 1, pp. 23–34, 2021, ISSN: 1476-8305.
@article{pmid30873919,
title = {Irregular eating patterns associate with hypomanic symptoms in bipolar disorders},
author = {Asli Buyukkurt and Clément Bourguignon and Christina Antinora and Elisabeth Farquhar and Xiaoya Gao and Eloise Passarella and Duncan Sibthorpe and Karine Gou and Sybille Saury and Serge Beaulieu and Kai-Florian Storch and Outi Linnaranta},
doi = {10.1080/1028415X.2019.1587136},
issn = {1476-8305},
year = {2021},
date = {2021-01-01},
journal = {Nutr Neurosci},
volume = {24},
number = {1},
pages = {23--34},
abstract = { We present novel dimensional methods to describe the timing of eating in psychopathology. We focused on the relationship between current mood in bipolar disorder (BD) and the stability of the temporal pattern of daily eating events. Consenting BD patients ( = 69) from an outpatient, tertiary care clinic completed hourly charts of mood and eating for two weeks. Mood was also evaluated with Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). Illustrative displays, or eatograms, enabling visualization of all recorded eating events were used to guide assessment of the temporal structure of eating across the two week assessment period. We computed indices to quantify irregularities in timing of eating, namely I, I and I for the variability of frequency, timing, and interval of eating events, respectively. In this cohort, irregular temporal pattern of eating correlated with hypomanic symptoms (YMRS with I, Spearman rank order rh = 0.28, = .019, with I, rh = 0.44, < .001, and with I rh = 0.38, = .001), but not depressive symptoms or anthropometric measures. : Our data suggest a link between the instability of the temporal order of daily eating and mood. The dimensional measures for eating pattern introduced here enable future investigations of correlations with psychopathology.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
We present novel dimensional methods to describe the timing of eating in psychopathology. We focused on the relationship between current mood in bipolar disorder (BD) and the stability of the temporal pattern of daily eating events. Consenting BD patients ( = 69) from an outpatient, tertiary care clinic completed hourly charts of mood and eating for two weeks. Mood was also evaluated with Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). Illustrative displays, or eatograms, enabling visualization of all recorded eating events were used to guide assessment of the temporal structure of eating across the two week assessment period. We computed indices to quantify irregularities in timing of eating, namely I, I and I for the variability of frequency, timing, and interval of eating events, respectively. In this cohort, irregular temporal pattern of eating correlated with hypomanic symptoms (YMRS with I, Spearman rank order rh = 0.28, = .019, with I, rh = 0.44, < .001, and with I rh = 0.38, = .001), but not depressive symptoms or anthropometric measures. : Our data suggest a link between the instability of the temporal order of daily eating and mood. The dimensional measures for eating pattern introduced here enable future investigations of correlations with psychopathology.
2020
Bertrand, Lia; Bourguignon, Clément; Beaulieu, Serge; Storch, Kai-Florian; Linnaranta, Outi
Suicidal Ideation and Insomnia in Bipolar Disorders: Idéation suicidaire et insomnie dans les troubles bipolaires Journal Article
In: Can J Psychiatry, vol. 65, no. 11, pp. 802–810, 2020, ISSN: 1497-0015.
@article{pmid32856463,
title = {Suicidal Ideation and Insomnia in Bipolar Disorders: Idéation suicidaire et insomnie dans les troubles bipolaires},
author = {Lia Bertrand and Clément Bourguignon and Serge Beaulieu and Kai-Florian Storch and Outi Linnaranta},
doi = {10.1177/0706743720952226},
issn = {1497-0015},
year = {2020},
date = {2020-11-01},
journal = {Can J Psychiatry},
volume = {65},
number = {11},
pages = {802--810},
abstract = {OBJECTIVE: Bipolar disorder (BD) confers elevated suicide risk and associates with misaligned circadian rhythm. Real-time monitoring of objectively measured sleep is a novel approach to detect and prevent suicidal behavior. We aimed at understanding associations between subjective insomnia and actigraphy data with severity of suicidal ideation in BDs.nnMETHODS: This prospective cohort study comprised 76 outpatients with a BD aged 18 to 65 inclusively. Main measures included 10 consecutive days of wrist actigraphy; the Athens Insomnia Scale (AIS); the Montgomery-Åsberg Depression Rating Scale (MADRS); the Quick Inventory of Depressive Symptoms-16, self-rating (QIDS-SR-16); and the Columbia Suicide Severity Rating Scale. Diagnoses, medications, and suicide attempts were obtained from chart review.nnRESULTS: Suicidal ideation correlated moderately with subjective insomnia (AIS with QIDS-SR-16 item 12 ρ =0.26, = 0.03; MADRS item 10 ρ = 0.33, = 0.003). Graphical sleep patterns showed that suicidal patients were enriched among the most fragmented sleep patterns, and this was confirmed by correlations of suicidal ideation with actigraphy data at 2 visits. Patients with lifetime suicide attempts ( = 8) had more varied objective sleep (a higher standard deviation of center of daily inactivity [0.64 vs. 0.26, = 0.01], consolidation of daily inactivity [0.18 vs. 0.10, = <0.001], sleep offset [3.02 hours vs. 1.90 hours, = <0.001], and total sleep [105 vs. 69 minutes, = 0.02], and a lower consolidation of daily inactivity [0.65 vs. 0.79, = 0.03]).nnCONCLUSIONS: Subjective insomnia, a nonstigmatized symptom, can complement suicidality screens. Longer follow-ups and larger samples are warranted to understand whether real-time sleep monitoring predicts suicidal ideation in patient subgroups or individually.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: Bipolar disorder (BD) confers elevated suicide risk and associates with misaligned circadian rhythm. Real-time monitoring of objectively measured sleep is a novel approach to detect and prevent suicidal behavior. We aimed at understanding associations between subjective insomnia and actigraphy data with severity of suicidal ideation in BDs.nnMETHODS: This prospective cohort study comprised 76 outpatients with a BD aged 18 to 65 inclusively. Main measures included 10 consecutive days of wrist actigraphy; the Athens Insomnia Scale (AIS); the Montgomery-Åsberg Depression Rating Scale (MADRS); the Quick Inventory of Depressive Symptoms-16, self-rating (QIDS-SR-16); and the Columbia Suicide Severity Rating Scale. Diagnoses, medications, and suicide attempts were obtained from chart review.nnRESULTS: Suicidal ideation correlated moderately with subjective insomnia (AIS with QIDS-SR-16 item 12 ρ =0.26, = 0.03; MADRS item 10 ρ = 0.33, = 0.003). Graphical sleep patterns showed that suicidal patients were enriched among the most fragmented sleep patterns, and this was confirmed by correlations of suicidal ideation with actigraphy data at 2 visits. Patients with lifetime suicide attempts ( = 8) had more varied objective sleep (a higher standard deviation of center of daily inactivity [0.64 vs. 0.26, = 0.01], consolidation of daily inactivity [0.18 vs. 0.10, = <0.001], sleep offset [3.02 hours vs. 1.90 hours, = <0.001], and total sleep [105 vs. 69 minutes, = 0.02], and a lower consolidation of daily inactivity [0.65 vs. 0.79, = 0.03]).nnCONCLUSIONS: Subjective insomnia, a nonstigmatized symptom, can complement suicidality screens. Longer follow-ups and larger samples are warranted to understand whether real-time sleep monitoring predicts suicidal ideation in patient subgroups or individually.
Lavin-Gonzalez, Paola; Bourguignon, Clément; Crescenzi, Olivia; Beaulieu, Serge; Storch, Kai-Florian; Linnaranta, Outi
Inactograms and objective sleep measures as means to capture subjective sleep problems in patients with a bipolar disorder Journal Article
In: Bipolar Disord, vol. 22, no. 7, pp. 722–730, 2020, ISSN: 1399-5618.
@article{pmid32232937,
title = {Inactograms and objective sleep measures as means to capture subjective sleep problems in patients with a bipolar disorder},
author = {Paola Lavin-Gonzalez and Clément Bourguignon and Olivia Crescenzi and Serge Beaulieu and Kai-Florian Storch and Outi Linnaranta},
doi = {10.1111/bdi.12903},
issn = {1399-5618},
year = {2020},
date = {2020-11-01},
journal = {Bipolar Disord},
volume = {22},
number = {7},
pages = {722--730},
abstract = {BACKGROUND: Sleep problems are common in bipolar disorders (BDs). To objectively characterize these problems in BDs, further methodological development is needed to capture subjective insomnia.nnAIM: To test psychometric properties of the Athens Insomnia Scale (AIS), and associations with actigraphy-derived measures, applying modifications in actigraphy data processing to capture features of perturbed sleep in patients with a BD.nnMETHODS: Seventy-four patients completed the AIS and the Quick Inventory of Depressive Symptomatology, self-report (QIDS-SR-16). Locomotor activity was continuously recorded by wrist actigraphy for ≥10 consecutive days. We computed the sleep onset/offset, the center of daily inactivity (CenDI), as a proxy for chronotype, and the degree of consolidation of daily inactivity (ConDI), as a proxy for sleep-wake rhythm strength.nnRESULTS: AIS showed good psychometric properties (Cronbach's alpha = 0.84; test-retest correlation = 0.84, P<.001). Subjective sleep problems correlated moderately with a later sleep phase (CenDI with AIS rho = 0.34, P = .003), lower consolidation (ConDI with AIS rho = -0.22, P = .05; with QIDS-SR-16 rho = -0.27, P = .019), later timing of sleep offset (with AIS rho = 0.49, P = ≤.001, with QIDS-SR-16 rho = 0.36, P = .002), and longer total sleep (with AIS rho = 0.29, P = .012, with QIDS-SR-16 rho = 0.41, P = ≤.001). While AIS was psychometrically more solid, correlations with objective sleep were more consistent across time for QIDS-SR-16.nnCONCLUSIONS: AIS and QIDS-SR-16 are suitable for clinical screening of sleep problems among patients with a BD. Subjective insomnia associated with objective measures. For clinical and research purposes, actigraphy and data visualization on inactograms are useful for accurate longitudinal characterization of sleep patterns.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Sleep problems are common in bipolar disorders (BDs). To objectively characterize these problems in BDs, further methodological development is needed to capture subjective insomnia.nnAIM: To test psychometric properties of the Athens Insomnia Scale (AIS), and associations with actigraphy-derived measures, applying modifications in actigraphy data processing to capture features of perturbed sleep in patients with a BD.nnMETHODS: Seventy-four patients completed the AIS and the Quick Inventory of Depressive Symptomatology, self-report (QIDS-SR-16). Locomotor activity was continuously recorded by wrist actigraphy for ≥10 consecutive days. We computed the sleep onset/offset, the center of daily inactivity (CenDI), as a proxy for chronotype, and the degree of consolidation of daily inactivity (ConDI), as a proxy for sleep-wake rhythm strength.nnRESULTS: AIS showed good psychometric properties (Cronbach's alpha = 0.84; test-retest correlation = 0.84, P<.001). Subjective sleep problems correlated moderately with a later sleep phase (CenDI with AIS rho = 0.34, P = .003), lower consolidation (ConDI with AIS rho = -0.22, P = .05; with QIDS-SR-16 rho = -0.27, P = .019), later timing of sleep offset (with AIS rho = 0.49, P = ≤.001, with QIDS-SR-16 rho = 0.36, P = .002), and longer total sleep (with AIS rho = 0.29, P = .012, with QIDS-SR-16 rho = 0.41, P = ≤.001). While AIS was psychometrically more solid, correlations with objective sleep were more consistent across time for QIDS-SR-16.nnCONCLUSIONS: AIS and QIDS-SR-16 are suitable for clinical screening of sleep problems among patients with a BD. Subjective insomnia associated with objective measures. For clinical and research purposes, actigraphy and data visualization on inactograms are useful for accurate longitudinal characterization of sleep patterns.
Tuineag, Maria; Therman, Sebastian; Lindgren, Maija; Rouanet, Manon; Nahon, Sara; Bertrand, Lia; Saury, Sybille; Renaud, Suzanne; Beaulieu, Serge; Linnaranta, Outi
Dissociative symptoms as measured by the Cambridge Depersonalization Scale in patients with a bipolar disorder Journal Article
In: J Affect Disord, vol. 263, pp. 187–192, 2020, ISSN: 1573-2517.
@article{pmid31818776,
title = {Dissociative symptoms as measured by the Cambridge Depersonalization Scale in patients with a bipolar disorder},
author = {Maria Tuineag and Sebastian Therman and Maija Lindgren and Manon Rouanet and Sara Nahon and Lia Bertrand and Sybille Saury and Suzanne Renaud and Serge Beaulieu and Outi Linnaranta},
doi = {10.1016/j.jad.2019.11.137},
issn = {1573-2517},
year = {2020},
date = {2020-02-01},
journal = {J Affect Disord},
volume = {263},
pages = {187--192},
abstract = {BACKGROUND: The Cambridge Depersonalization Scale (CDS) characterizes the quality, frequency, and duration of dissociative symptoms. While the psychometric properties of the CDS have been evaluated in primary dissociative disorder, this has been insufficiently addressed among other psychiatric patient groups such as patients with a bipolar disorder (BD).nnMETHODS: Outpatients with variable mood (n = 73) responded to a survey that assessed dissociative symptoms and other characteristics. We used factor analysis and McDonald's omega to evaluate psychometric properties of the CDS, and correlations with other characteristics.nnRESULTS: Previously suggested multifactorial models of the CDS were not supported, but the single-dimensional model fit both dichotomized (p = 0.31, CFI = 0.99, RMSEA = 0.02, ECV 70%) and trichotomized CDS responses (p = 0.06, CFI = 0.96, RMSEA = 0.04, ECV 47%). The CDS showed high internal consistency (ω = 0.96). CDS factor scores correlated with symptom severity on the Quick Inventory for Depressive Symptoms (QIDS-SR-16) (ρ = 0.59), the Social Phobia Inventory (ρ = 0.52), the American Association of Psychiatry Severity measure for Panic Disorders (ρ = 0.46), the Childhood Trauma Questionnaire (ρ = 0.44), and the Trauma Screening Questionnaire (ρ = 0.53). Two abbreviated versions of the CDS, retaining the best 14 or 7 items were proposed.nnLIMITATIONS: The sample size remained moderate.nnCONCLUSIONS: The CDS is a psychometrically sound, unidimensional measure with clinical impact to detect and characterize dissociative symptoms in BD patients. Establishing the reliability and validity of the abbreviated scales for screening necessitates further study.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: The Cambridge Depersonalization Scale (CDS) characterizes the quality, frequency, and duration of dissociative symptoms. While the psychometric properties of the CDS have been evaluated in primary dissociative disorder, this has been insufficiently addressed among other psychiatric patient groups such as patients with a bipolar disorder (BD).nnMETHODS: Outpatients with variable mood (n = 73) responded to a survey that assessed dissociative symptoms and other characteristics. We used factor analysis and McDonald's omega to evaluate psychometric properties of the CDS, and correlations with other characteristics.nnRESULTS: Previously suggested multifactorial models of the CDS were not supported, but the single-dimensional model fit both dichotomized (p = 0.31, CFI = 0.99, RMSEA = 0.02, ECV 70%) and trichotomized CDS responses (p = 0.06, CFI = 0.96, RMSEA = 0.04, ECV 47%). The CDS showed high internal consistency (ω = 0.96). CDS factor scores correlated with symptom severity on the Quick Inventory for Depressive Symptoms (QIDS-SR-16) (ρ = 0.59), the Social Phobia Inventory (ρ = 0.52), the American Association of Psychiatry Severity measure for Panic Disorders (ρ = 0.46), the Childhood Trauma Questionnaire (ρ = 0.44), and the Trauma Screening Questionnaire (ρ = 0.53). Two abbreviated versions of the CDS, retaining the best 14 or 7 items were proposed.nnLIMITATIONS: The sample size remained moderate.nnCONCLUSIONS: The CDS is a psychometrically sound, unidimensional measure with clinical impact to detect and characterize dissociative symptoms in BD patients. Establishing the reliability and validity of the abbreviated scales for screening necessitates further study.
Soh, Jocelyn Fotso; Almadani, Ahmad; Beaulieu, Serge; Rajji, Tarek; Mulsant, Benoit H; Su, Chien-Lin; Renaud, Suzane; Mucsi, Istvan; Torres-Platas, S Gabriela; Levinson, Andrea; Schaffer, Ayal; Dols, Annemiek; Cervantes, Pablo; Low, Nancy; Herrmann, Nathan; Mantere, Outi; Rej, Soham
In: J Affect Disord, vol. 262, pp. 149–154, 2020, ISSN: 1573-2517.
@article{pmid31733459,
title = {The effect of atorvastatin on cognition and mood in bipolar disorder and unipolar depression patients: A secondary analysis of a randomized controlled trial},
author = {Jocelyn Fotso Soh and Ahmad Almadani and Serge Beaulieu and Tarek Rajji and Benoit H Mulsant and Chien-Lin Su and Suzane Renaud and Istvan Mucsi and S Gabriela Torres-Platas and Andrea Levinson and Ayal Schaffer and Annemiek Dols and Pablo Cervantes and Nancy Low and Nathan Herrmann and Outi Mantere and Soham Rej},
doi = {10.1016/j.jad.2019.11.013},
issn = {1573-2517},
year = {2020},
date = {2020-02-01},
journal = {J Affect Disord},
volume = {262},
pages = {149--154},
abstract = {OBJECTIVES: Statins have recently been linked to having effects on cognition and mood in mood disorders, though results are mixed. In this paper, we use data from a recent randomized controlled trial (RCT) to examine the effect of statins on cognition and mood in patients with Bipolar Disorder (BD) and Major Depressive Disorder (MDD).nnMETHODS: This is a secondary analysis of a randomized, double-blind, placebo-controlled clinical trial (n = 60) originally designed to examine the effect of atorvastatin (n = 27) versus placebo (n = 33) for lithium-induced diabetes insipidus in BD and MDD patients who were using lithium. For this analysis, the primary outcome was global cognition Z-score at 12-weeks adjusted for baseline. The secondary cognition outcomes were (1) Screen for Cognitive Impairment in Psychiatry (SCIP), and (2) executive function Z-score. The primary mood outcome (secondary outcome of this analysis) was depression relapse during 12-week follow-up (Mongomery Asberg Depression Rating Scale (MADRS) ≥10). The secondary mood outcomes were (1) relapse rate into a manic episode, and (2) relapse rate into any mood episode.nnRESULTS: After 12 weeks follow-up, atorvastatin and placebo groups did not differ in terms of global cognition Z-score (β = -0.009287 (-0.1698,0.1512), p-value = 0.91). Similarly, composite Z-scores for SCIP and executive functions did not differ significantly. Depression relapse during 12-week follow-up was not significantly different between the groups (χ (1) = 0.148, p-value = 0.70). Similarly, there was no difference between groups regarding relapse into mania.nnCONCLUSION: In BD and MDD patients with lithium-induced nephrogenic diabetes insipidus randomized to atorvastatin or placebo, we found no significant differences in cognition and mood outcomes at 12-week follow-up.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Statins have recently been linked to having effects on cognition and mood in mood disorders, though results are mixed. In this paper, we use data from a recent randomized controlled trial (RCT) to examine the effect of statins on cognition and mood in patients with Bipolar Disorder (BD) and Major Depressive Disorder (MDD).nnMETHODS: This is a secondary analysis of a randomized, double-blind, placebo-controlled clinical trial (n = 60) originally designed to examine the effect of atorvastatin (n = 27) versus placebo (n = 33) for lithium-induced diabetes insipidus in BD and MDD patients who were using lithium. For this analysis, the primary outcome was global cognition Z-score at 12-weeks adjusted for baseline. The secondary cognition outcomes were (1) Screen for Cognitive Impairment in Psychiatry (SCIP), and (2) executive function Z-score. The primary mood outcome (secondary outcome of this analysis) was depression relapse during 12-week follow-up (Mongomery Asberg Depression Rating Scale (MADRS) ≥10). The secondary mood outcomes were (1) relapse rate into a manic episode, and (2) relapse rate into any mood episode.nnRESULTS: After 12 weeks follow-up, atorvastatin and placebo groups did not differ in terms of global cognition Z-score (β = -0.009287 (-0.1698,0.1512), p-value = 0.91). Similarly, composite Z-scores for SCIP and executive functions did not differ significantly. Depression relapse during 12-week follow-up was not significantly different between the groups (χ (1) = 0.148, p-value = 0.70). Similarly, there was no difference between groups regarding relapse into mania.nnCONCLUSION: In BD and MDD patients with lithium-induced nephrogenic diabetes insipidus randomized to atorvastatin or placebo, we found no significant differences in cognition and mood outcomes at 12-week follow-up.
Sayegh, Liliane; Touré, El Hadj; Farquhar, Elisabeth; Beaulieu, Serge; Renaud, Suzane; Rej, Soham; Perreault, Michel
Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression Journal Article
In: Front Psychiatry, vol. 11, pp. 565681, 2020, ISSN: 1664-0640.
@article{pmid33173513,
title = {Group Cognitive Behavioral Analysis System of Psychotherapy (CBASP): A Pilot Study for Bipolar Depression},
author = {Liliane Sayegh and El Hadj Touré and Elisabeth Farquhar and Serge Beaulieu and Suzane Renaud and Soham Rej and Michel Perreault},
doi = {10.3389/fpsyt.2020.565681},
issn = {1664-0640},
year = {2020},
date = {2020-01-01},
journal = {Front Psychiatry},
volume = {11},
pages = {565681},
abstract = {OBJECTIVES: Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is an individually administered treatment model designed specifically for Persistent Depression however bipolar patients have traditionally been excluded from CBASP studies. There is a perception that bipolar depression will be harder to treat and requires a unique psychological approach. This pilot study reports on the feasibility of administering the same 20-week manualized group CBASP therapy with bipolar patients currently in a depressive episode.nnMETHODS: This non-randomized, single-arm prospective pilot study, reports on an exploration of benefits to bipolar depressed patients (n=26) of the same 20-week group CBASP intervention administered to unipolar depressed patients (n=81). The clinical trial for the initial phase examining benefits of the manualized 20-week group CBASP intervention with unipolar patients was registered with the ISRCTN registry, study ID: ISRCTN95149444. Results reported here include mixed ANOVA analyses, across group treatment models and diagnostic categories. Changes over time in self-reported depressive symptoms (Inventory of Depressive Symptoms -IDS-SR), self-reported social functioning, interpersonal problems and interpersonal dispositions are documented for all patients. An exploratory longitudinal latent class analysis was used to examine patients' trajectories of improvement in depressive symptoms. Finally, the best predictors of change in reported depressive symptoms were explored with a logistic regression for all patients.nnRESULTS: Improvements in depressive symptoms and in social functioning over time were significant for all patients with bipolar patients trending towards a greater improvement in depressive symptoms after controlling for baseline differences. An exploratory Latent Class Analysis identified two different treatment trajectories for the entire sample: 1) moderate to severely depressed patients who improved significantly (49%) and 2) severely depressed patients who did not improve (51%). The best predictors of non-response to group therapy include high baseline problems in social functioning and low rates of self-reported Perceived Improvements in overall health.nnCONCLUSION: Bipolar patients in a depressive episode appear to benefit from the same 20-week group CBASP model designed originally for the treatment of Persistent Depressive Disorder. Bipolar patients seem more easily mobilized both during and outside of group therapy sessions and report more interpersonal confidence and more agency than unipolar depressed patients.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is an individually administered treatment model designed specifically for Persistent Depression however bipolar patients have traditionally been excluded from CBASP studies. There is a perception that bipolar depression will be harder to treat and requires a unique psychological approach. This pilot study reports on the feasibility of administering the same 20-week manualized group CBASP therapy with bipolar patients currently in a depressive episode.nnMETHODS: This non-randomized, single-arm prospective pilot study, reports on an exploration of benefits to bipolar depressed patients (n=26) of the same 20-week group CBASP intervention administered to unipolar depressed patients (n=81). The clinical trial for the initial phase examining benefits of the manualized 20-week group CBASP intervention with unipolar patients was registered with the ISRCTN registry, study ID: ISRCTN95149444. Results reported here include mixed ANOVA analyses, across group treatment models and diagnostic categories. Changes over time in self-reported depressive symptoms (Inventory of Depressive Symptoms -IDS-SR), self-reported social functioning, interpersonal problems and interpersonal dispositions are documented for all patients. An exploratory longitudinal latent class analysis was used to examine patients' trajectories of improvement in depressive symptoms. Finally, the best predictors of change in reported depressive symptoms were explored with a logistic regression for all patients.nnRESULTS: Improvements in depressive symptoms and in social functioning over time were significant for all patients with bipolar patients trending towards a greater improvement in depressive symptoms after controlling for baseline differences. An exploratory Latent Class Analysis identified two different treatment trajectories for the entire sample: 1) moderate to severely depressed patients who improved significantly (49%) and 2) severely depressed patients who did not improve (51%). The best predictors of non-response to group therapy include high baseline problems in social functioning and low rates of self-reported Perceived Improvements in overall health.nnCONCLUSION: Bipolar patients in a depressive episode appear to benefit from the same 20-week group CBASP model designed originally for the treatment of Persistent Depressive Disorder. Bipolar patients seem more easily mobilized both during and outside of group therapy sessions and report more interpersonal confidence and more agency than unipolar depressed patients.
2018
Soh, Jocelyn Fotso; Torres-Platas, Susana G; Beaulieu, Serge; Mantere, Outi; Platt, Robert; Mucsi, Istvan; Saury, Sybille; Renaud, Suzane; Levinson, Andrea; Andreazza, Ana C; Mulsant, Benoit H; Müller, Daniel; Schaffer, Ayal; Dols, Annemiek; Cervantes, Pablo; Low, Nancy Cp; Herrmann, Nathan; Christensen, Birgitte M; Trepiccione, Francesco; Rajji, Tarek; Rej, Soham
Atorvastatin in the treatment of Lithium-induced nephrogenic diabetes insipidus: the protocol of a randomized controlled trial Journal Article
In: BMC Psychiatry, vol. 18, no. 1, pp. 227, 2018, ISSN: 1471-244X.
@article{pmid30012135,
title = {Atorvastatin in the treatment of Lithium-induced nephrogenic diabetes insipidus: the protocol of a randomized controlled trial},
author = {Jocelyn Fotso Soh and Susana G Torres-Platas and Serge Beaulieu and Outi Mantere and Robert Platt and Istvan Mucsi and Sybille Saury and Suzane Renaud and Andrea Levinson and Ana C Andreazza and Benoit H Mulsant and Daniel Müller and Ayal Schaffer and Annemiek Dols and Pablo Cervantes and Nancy Cp Low and Nathan Herrmann and Birgitte M Christensen and Francesco Trepiccione and Tarek Rajji and Soham Rej},
doi = {10.1186/s12888-018-1793-9},
issn = {1471-244X},
year = {2018},
date = {2018-07-01},
journal = {BMC Psychiatry},
volume = {18},
number = {1},
pages = {227},
abstract = {BACKGROUND: Lithium is the gold-standard treatment for bipolar disorder, is highly effective in treating major depressive disorder, and has anti-suicidal properties. However, clinicians are increasingly avoiding lithium largely due to fears of renal toxicity. Nephrogenic Diabetes Insipidus (NDI) occurs in 15-20% of lithium users and predicts a 2-3 times increased risk of chronic kidney disease (CKD). We recently found that use of statins is associated with lower NDI risk in a cross-sectional study. In this current paper, we describe the methodology of a randomized controlled trial (RCT) to treat lithium-induced NDI using atorvastatin.nnMETHODS: We will conduct a 12-week, double-blind placebo-controlled RCT of atorvastatin for lithium-induced NDI at McGill University, Montreal, Canada. We will recruit 60 current lithium users, aged 18-85, who have indicators of NDI, which we defined as urine osmolality (UOsm) < 600 mOsm/kg after 10-h fluid restriction. We will randomize patients to atorvastatin (20 mg/day) or placebo for 12 weeks. We will examine whether this improves measures of NDI: UOsm and aquaporin (AQP2) excretion at 12-week follow-up, adjusted for baseline.nnRESULTS: Not applicable.nnCONCLUSION: The aim of this clinical trial is to provide preliminary data about the efficacy of atorvastatin in treating NDI. If successful, lithium could theoretically be used more safely in patients with a reduced subsequent risk of CKD, hypernatremia, and acute kidney injury (AKI). If future definitive trials confirm this, this could potentially allow more patients to benefit from lithium, while minimizing renal risk.nnTRIAL REGISTRATION: ClinicalTrials.gov NCT02967653 . Registered in February 2017.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Lithium is the gold-standard treatment for bipolar disorder, is highly effective in treating major depressive disorder, and has anti-suicidal properties. However, clinicians are increasingly avoiding lithium largely due to fears of renal toxicity. Nephrogenic Diabetes Insipidus (NDI) occurs in 15-20% of lithium users and predicts a 2-3 times increased risk of chronic kidney disease (CKD). We recently found that use of statins is associated with lower NDI risk in a cross-sectional study. In this current paper, we describe the methodology of a randomized controlled trial (RCT) to treat lithium-induced NDI using atorvastatin.nnMETHODS: We will conduct a 12-week, double-blind placebo-controlled RCT of atorvastatin for lithium-induced NDI at McGill University, Montreal, Canada. We will recruit 60 current lithium users, aged 18-85, who have indicators of NDI, which we defined as urine osmolality (UOsm) < 600 mOsm/kg after 10-h fluid restriction. We will randomize patients to atorvastatin (20 mg/day) or placebo for 12 weeks. We will examine whether this improves measures of NDI: UOsm and aquaporin (AQP2) excretion at 12-week follow-up, adjusted for baseline.nnRESULTS: Not applicable.nnCONCLUSION: The aim of this clinical trial is to provide preliminary data about the efficacy of atorvastatin in treating NDI. If successful, lithium could theoretically be used more safely in patients with a reduced subsequent risk of CKD, hypernatremia, and acute kidney injury (AKI). If future definitive trials confirm this, this could potentially allow more patients to benefit from lithium, while minimizing renal risk.nnTRIAL REGISTRATION: ClinicalTrials.gov NCT02967653 . Registered in February 2017.