In the largest study of its kind, involving more than 50,000 subjects in 14 countries, researchers at the Icahn School of Medicine at Mount Sinai and more than 200 collaborating institutions have identified 20 new genetic associations with one of the most prevalent and elusive mental illnesses of our time — bipolar disorder. The study is reported in the May 2019 issue of Nature Genetics.
The elevated morbidity and mortality associated with bipolar disorder make it a major public health problem and leading contributor to the global burden of disease. The identification of genes associated with it can help identify therapeutic targets for treatment and prevention.
Bipolar disorder, a neuropsychiatric condition characterized by dramatic shifts in a person’s mood, affects approximately 60 million people globally, 10 million of them in the United States. Unlike other illnesses, bipolar disorder has been found to affect men, women, and people of all ethnic groups equally. While genetic and environmental factors have been demonstrated to play a role in the illness, the exact cause of bipolar disorder remains unknown.
Growing up in impoverished urban neighborhoods more than doubles your chances over the average person of developing a psychosis-spectrum disorder by the time you reach middle adulthood, according to a new UC Davis and Concordia University study of nearly 4,000 families who were monitored over 30 years.
The results of the study suggest that intervention through social policies and investment in neighborhood improvements, as well as identifying those most in need of help by observing certain child behaviors, could prevent future debilitating illnesses and the societal and personal costs associated with them, said the study’s authors.
“One important message to take from this study is that the stresses and chronic day-to-day challenges of living in under-resourced or impoverished communities can undermine the well-being of individuals whether they seem to have a vulnerability or not,” said Paul D. Hastings, professor in the Department of Psychology at UC Davis and the lead author of the paper. He explained that while heredity is a major factor in predicting schizophrenia, bipolar disorder and other disorders involving psychoses — that is, breaks with reality, like delusional beliefs and hallucinations — this study provides clear evidence that environmental factors experienced in childhood also affect future mental health.
Mania and hypomania are periods where a person feels elated, very active, and full of energy. Hypomania is a milder form of mania.
Mania and hypomania both involve periods when the individual feels excited or experiences an energized mood. They differ in how severe these mood changes are:
Mania is a severe episode that may last for a week or more. A person may feel uncontrollably elated and very high in energy. These symptoms interfere with daily life, and in severe cases, a person may need to go to the hospital.
Hypomania is an episode that lasts for a few days. People may feel very good and function well. Family or friends may notice mood or activity changes, while the person with the hypomania may not.
Diet quality can affect many aspects of one’s physical health and psychological well-being. New research investigates whether or not these factors can also affect the effectiveness of treatments for mood disorders — particularly bipolar.
The moods of people who have bipolar disorder fluctuate between two extremes.
These are the “highs,” during which the person feels euphoric and may engage in dangerous behaviors, and the “lows,” characterized by depression and lethargy.
Since two opposite mood extremes characterize this disorder, it is often difficult to treat both the “highs” (or “manic episodes”) and the “lows” (or “depressive episodes”) with the same efficacy.
At the beginning of his second year at Loughborough University, Rahul Mathasing started struggling. His moods were becoming darker, his motivation disappeared and he started missing lectures. He approached the university medical centre, which referred him to the local NHS community mental health team. His pattern of behaviour – manic episodes in which he couldn’t concentrate or sleep, as well as episodes of very low moods – led to a diagnosis, in February 2015, of bipolar disorder.
The systems engineering student, who continues to see a psychiatrist and is on medication to treat his disorder, has had help from the students’ union, the medical centre, and his department, which gave him a leave of absence: “They’ve done every thing they can to help me get to a level I’m happy with.”
Students can be more stressed and anxious than other young people. “You don’t have family around you, necessarily, and you are probably having a massive shift in your support systems,” says Micha Frazer-Carroll, welfare and rights officer at the University of Cambridge students’ union.
The tech sector is built on bright minds developing new solutions to create economic or social impact. This fast-paced industry has high stakes, which require people to meet even higher expectations. Many individuals within the sector — especially startup founders — have small teams (meaning each person serves in multiple roles), work long hours, second jobs or are still in school and constantly worry about “making it.”
At the DMZ, we see that many entrepreneurs are still not talking openly about their mental well-being. And these challenges aren’t special to our organization. Mental health concerns in tech entrepreneurship are often referred to as “founder’s blues.” Between 2011 and 2017, founder’s blues has contributed to a number of high-profile suicides in the startup world, including Aaron Swartz, co-founder of Reddit.
Researchers from the University of California found that 72% of entrepreneurs surveyed self-reported mental health concerns. And about 49% disclosed they deal with ADD, ADHD, bipolar disorder, addiction, depression or anxiety. These figures were described as “significantly higher” than non-entrepreneurs.
In a striking new finding, researchers at the UC Davis MIND Institute found that typically-developing children gain more neurons in a region of the brain that governs social and emotional behavior, the amygdala, as they become adults. This phenomenon does not happen in people with autism spectrum disorder (ASD). Instead, children with ASD have too many neurons early on and then appear to lose those neurons as they become adults. The findings were published today in the journal Proceedings of the National Academy of Sciences (PNAS).
The amygdala is a small almond-shaped group of 13 regions (nuclei) that work as a danger detector in the brain to regulate anxiety and social interactions. Amygdala dysfunction has been linked to many psychiatric and neurodevelopmental disorders, including ASD, schizophrenia, bipolar disorder and depression.
“The amygdala is a unique brain structure in that it grows dramatically during adolescence, longer than other brain regions, as we become more socially and emotionally mature,” said Cynthia Schumann, associate professor in the Department of Psychiatry and Behavioral Sciences at the UC Davis MIND Institute and senior author of the paper. “Any deviation from this normal path of development can profoundly influence human behavior.” To understand what cellular factors underlie amygdala development, the team studied 52 postmortem human brains, both neurotypical and ASD, ranging from 2 to 48 years of age.
Evidence has been mounting that some mental disorders share many of the same genetic risk factors. Now, researchers have discovered that this overlap extends to the molecular level – some of these suspect genes also turn on-and-off similarly in the brains of people with autism spectrum disorder (ASD), schizophrenia, and bipolar disorder. These molecular signatures may hold clues to what goes wrong in the brain in these disorders—and potentially ways to better treat or even prevent them.
In search of such clues, Drs. Daniel Geschwind and Michael Gandalof the University of California Los Angeles (UCLA), and colleagues, examined gene expression in postmortem brains of people who had been diagnosed with autism spectrum disorder (ASD), schizophrenia, bipolar disorder, major depressive disorder, or alcoholism. One of the largest such efforts of its kind to date, the study, funded by the National Institute of Mental Health (NIMH), tapped brain molecular data resources gathered through the NIMH-funded PsychENCODE consortium, a data-sharing collaboration among NIMH grantees.
Antipsychotic drugs — which transformed mental health care following their chance discovery in the mid-20th Century — may finally be poised for a long-overdue makeover incorporating structure-based design. Scientists funded by the National Institutes of Health have achieved a landmark of psychiatric neuropharmacology: deciphering the molecular structure of a widely prescribed antipsychotic docked in its key receptor. They are hopeful that this discovery may hold secrets to designing better treatments for schizophrenia, bipolar disorder, and other mental illnesses.
“For the first time, we can understand precisely how atypical antipsychotic drugs bind to their primary molecular target in the human brain,” explained Dr. Laurie Nadler, chief of the neuropharmacology program at the National Institute of Mental Health (NIMH), which co-funded the study along with the National Institute of General Medical Sciences and the National Cancer Institute. “This discovery opens the way for the rational design of a new generation of antipsychotic drugs, hopefully with more desirable effects and fewer side effects.”
Two patterns of antecedent or “prodromal” psychiatric symptoms may help to identify young persons at increased risk of developing bipolar disorder (BD), according to a new analysis in the Harvard Review of Psychiatry.
Early signs of BD can fall into a relatively characteristic “homotypic” pattern, consisting mainly of symptoms or other features associated with mood disorders; or a “heterotypic” pattern of other symptoms including anxiety and disruptive behavior. Environmental risk factors and exposures can also contribute to BD risk, according to the analysis by Ciro Marangoni, MD, at the Department of Mental Health, Mater Salutis Hospital, Legnato, Italy; Gianni L. Faedda, MD, Director of the Mood Disorder Center of New York, NY, and Co-Chairman of a Task Force of the International Society for Bipolar Disorders on this topic; and Professor Ross J. Baldessarini, MD, Director of the International Consortium for Bipolar & Psychotic Disorders Research of the Mailman Research Center at McLean Hospital in Belmont, Mass.