A research study led by scientists from the Gregorio Marañón University Hospital in Madrid and the Network of Centres for Biomedical Research in Mental Health Networks (CIBERSAM) shows that adolescents experiencing a first outbreak of psychosis have lower levels of grey matter in their brains than healthy teenagers. Strangely, this change was seen in patients suffering from various psychoses, including bipolar disorder and schizophrenia.

The aim of the study was to examine and locate differences in the volume of grey matter in the brains of healthy people (controls) and individuals diagnosed with psychotic outbreaks in infancy or adolescence. The researchers broke such psychosis down into three sub-groups schizophrenia, bipolar disorder and other psychoses that did not fit into either of the other two classifications.

The study, published recently in the Journal of the American Academy of Child and Adolescent Psychiatry, analysed a sample of 121 people aged between 7 and 18, inclusive. All the patients and controls were examined using magnetic resonance imaging in order to detect any possible changes in the structure of their brains.

“The interesting thing was that we found common alterations among those with two types of clinically-differentiated psychoses, schizophrenia and bipolar disorder, and this could help to improve diagnosis of these illnesses,” Santiago Reig, one of the study’s authors and a researcher in the Medical Imaging Laboratory of the Gregorio Marañón Hospital, tells SINC.

The study confirmed these lower levels of grey matter, the brain substance in which neurone cells are concentrated. This lack, which was shared between the schizophrenia and type 1 bipolar diaorder sufferers, means the functions of this part of the brain are “somehow atrophied”.

In addition, the technique used by the experts can pinpoint the location of these alterations. For example, “patients with early psychotic outbreaks (before the age of 18) showed alterations in the medial prefrontal gyrus region of the brain, which controls processes such as cognition and the regulation of sensations”, says Reig.

Improving diagnosis

“Anything that helps to detect alterations shared between distinct pathologies can help in the development of drugs and in finding common characteristics between these different diseases,” the researcher tells SINC. “Results like these are fundamental for the diagnosis and treatment of illnesses,” he adds.

However, it is important not to draw any causal link between alterations in this area of the brain and the appearance of these pathologies. Psychiatric disorders need more complex diagnosis. What the research does show, however, is that the majority of people with schizophrenia and type 1 bipolar disorder do suffer from this lack of grey matter and the majority of healthy people have normal levels of this substance.

“We still do not know whether this loss of grey matter is caused by the disorder or not,” says Reig. This is just one more piece of the puzzle to help in understanding common features of psychiatric disorders. “Maybe relating these developments with other new findings will one day help us to solve the riddle of psychiatric disorders,” he concludes.

Plataforma SINC
http://www.plataformasinc.es

• Mental Illness Was One Of The Costliest Conditions Between 1996 To 2006
• What Rorschach Tests Really Tell Us
• Buy Seroquel Online
• Having Parents With Bipolar Disorder Associated With Increased Risk Of Psychiatric Disorders

Schizophrenia and bipolar disorder have the same genetic causes, according to a study from Karolinska Institutet published today in the highly respected journal The Lancet. The results throw the current separate classification of the diseases into question.

Schizophrenia and bipolar disorder (also known as manic-depressive illness) are the two most common psychotic disorders. For over a century, the two diseases have been treated as distinct by clinical practitioners and researchers as regards definitions and risk factors. However, such strict classification has met increasing scepticism over the years, partly owing to the results of modern genetic science, which has shown that certain genes seem to affect both disorders.

To study whether schizophrenia and bipolar disorder have the same genetic causes, Swedish scientists analysed the records of two million families, including 35,985 patients with schizophrenia, 40,487 patients with bipolar disorder, and the blood relatives of both.

Their results show that members of families in which someone has either schizophrenia or bipolar disorder run an increased risk of developing the same condition. The results also show that this is chiefly the result of genetic factors, and only slightly due to shared environmental factors. The scientists also found that patients with schizophrenia are also more prone to bipolar disorder, and that relatives of patients with one of the diseases are more likely to have relatives with the other.

According to the researchers, the results, taken as a whole, provide convincing proof that schizophrenia and bipolar disorder are very much hereditary diseases, and that they share, in part, a common genetic cause. They also argue that it is important for clinicians and researchers to take this common genetic background into account when studying and treating schizophrenia and bipolar disorder.

The study was funded by the Swedish Council for Working Life and Social Research and the Swedish Research Council.

Publication:
“Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study”
Paul Lichtenstein, Benjamin H Yip, Camilla Bjork, Yudi Pawitan, Tyrone D Cannon, Patrick F Sullivan, Christina M Hultman
The Lancet, 16 January 2009

Download images: http://ki.se/pressimages

Karolinska Institutet is one of the leading medical universities in Europe. Through research, education and information, Karolinska Institutet contributes to improving human health. Each year, the Nobel Assembly at Karolinska Institutet awards the Nobel Prize in Physiology or Medicine.

Karolinska Institutet

• If Bipolar Disorder Is Over-Diagnosed, What Are The Actual Diagnoses?
• GPR50 gene linked to affective disorder]]>

Bipolar disorder appears to increase the risk of early death from medical illnesses, according to a literature review study published as the lead article this week in the journal Psychiatric Services.

The researchers comprehensively reviewed 17 studies involving more than 331,000 patients. Evidence suggested that people with bipolar disorder have a higher mortality from natural causes compared to people in the general population of similar age and gender but without mental illness. The various studies indicated that the risk was from 35 percent to 200 percent higher. The risk is the same for men and women. The most common conditions leading to premature death were heart disease, respiratory diseases, stroke, and endocrine problems such as diabetes.

“The review of data gathered from large population studies suggests that having bipolar disorder is similar to being a smoker in terms of increasing a person’s risk of early death,” said Dr. Wayne Katon, a University of Washington (UW) professor of psychiatry. He co-authored the study with third-year UW psychiatry resident Babak Roshanaei-Moghaddam. The article is titled, “Premature Mortality from General Medical Illnesses Among Persons with Bipolar Disorder: A Review.” Katon is a noted researcher on the interplay between life-shortening medical conditions and mood disorders.

People with bipolar disorder tend to have manic phases and depressed phases in their lives. During mania, they might be too wound up to sleep, their thoughts might race, and they might have boundless energy. During depression, they might feel painfully sad, hopeless, and immobilized.

In the past, the higher premature death rate among people with bipolar disorder was attributed to a higher rate of suicide and accidents. More recently, Katon said, researchers are finding that, while rates of suicides and accidents are indeed greater among those with bipolar disorder compared to the general population, they only partly account for the higher premature death rate. Emerging evidence, Katon said, shows that the majority of early deaths among people with bipolar disorder come from medical conditions.

As psychiatric conditions such as bipolar disorder become more treatable, Katon said, “We’re saving people from this illness and losing them to other medical illnesses.”

The possible reasons for this higher risk of premature death are manifold. Many factors could be contributing to poor physical health among people with bipolar disorder, according to the published report. These include unhealthy diet, binge eating, lack of exercise, smoking, substance abuse, social deprivation, living alone, homelessness, lack of access to health services, biased attitudes of health professionals towards people with psychiatric illnesses, failure among psychiatrists to address their patient’s medical problems, or delaying medical care because of the overriding need for psychiatric treatment.

Biological abnormalities associated with bipolar illness might also be shortening lives, Katon noted. The illness can stress the immune system and the hypothalamic-pituitary axis, a system that controls many body processes. Bipolar disorders also heighten the activity of the sympathetic nervous system, which sets off the fight-or-flight response to stress.

Katon also noted that some new antipsychotic medications used to successfully treat bipolar disorders are safer and more comfortable for the patient in some ways than previous medications, but can cause weight gain leading to obesity and other metabolic changes that predispose people to Type 2 diabetes. Some mood stabilizers, Katon added, also are associated with weight gain and metabolic disorders.

Katon mentioned new attempts to try to reduce premature death in people with bipolar disorder. These include providing psychiatrists and other mental health professionals with guidelines and training in monitoring their patients’ basic physical health and teaching them how to advise their patients about smoking cessation, exercise and other preventive measures.

“Changes are also occurring in medical schools to teach new physicians in all specialties how to recognize psychiatric illnesses and to understand the serious health risks associated with mental illness,” Katon said.

Increasingly, community mental health centers are adding primary-care physicians and nurse practitioners to the staff to see patients for medical conditions, he said. Medical specialty centers are also adding mental health professionals to diagnose and treat the depression, anxiety and other psychic distress that often accompany serious illnesses.

“Psychiatrists are now on the staff of a growing number of medical specialty clinics, such as centers for diabetes, heart disease and cancer, and at primary-care centers, such as family medicine practices,” Katon said. “Mental health professionals are working side-by-side with providers who treat medical illnesses. New approaches to health care and wellness programs are being tested at a number of places to find effective models for preventing premature deaths associated with bipolar disorder and other mental illnesses.”

—————————-
Article adapted by Medical News Today from original press release.
—————————-

Source: Leila Gray

University of Washington

• New Certified Reference Materials Offer Greater Certainty In Monitoring 3 Therapeutic Medications
• A receptor genes have selective influence on bipolar disorder phenotype]]>
• Interactive Autism Network Opens Its Doors To Adults With Autism