Association of Bipolar Disorder With Major Adverse Cardiovascular Events: A Population-Based Historical Cohort Study

Foroughi, Mahnoosh; Inojosa, Jose R. Medina; Lopez‐Jimenez, Francisco; Saeidifard, Farzane; Suarez, Laura; Stokin, Gorazd B.; Prieto, Miguel L.; Rocca, Walter A.; Frye, Mark A.; Morgan, Robert J.

doi:10.1097/psy.0000000000001017

Cited by 16 publications

(4 citation statements)

References 52 publications

(74 reference statements)

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“…This requires additional research, long-term evaluation, and association of ASA with other mood stabilizers. There is one more potential benefit of ASA—patients with BD are at increased risk of secondary vascular disease, thus the anticoagulant effect of ASA therapy may reduce their mortality [ 83 , 84 , 85 ].…”

Section: Discussionmentioning

confidence: 99%

Acetylsalicylic Acid and Mood Disorders: A Systematic Review

Dominiak

Gędek²,

Sikorska

et al. 2022

Pharmaceuticals

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The effects of acetylsalicylic acid (ASA) on mood disorders (MD) and on inflammatory parameters in preclinical and clinical studies have not yet been comprehensively evaluated. The aim of this study was to systematically summarize the available knowledge on this topic according to PRISMA guidelines. Data from preclinical and clinical studies were analyzed, considering the safety and efficacy of ASA in the treatment of MD and the correlation of inflammatory parameters with the effect of ASA treatment. Twenty-one studies were included. Both preclinical and clinical studies found evidence indicating the safety and efficacy of low-dose ASA in the treatment of all types of affective episodes in MD. Observational studies have indicated a reduced risk of all types of affective episodes in chronic low-dose ASA users (HR 0.92, 95% CI:0.88, 0.95, p < 0.0001). An association between ASA response and inflammatory parameters was found in preclinical studies, but this was not confirmed in clinical trials. Further long-term clinical trials evaluating the safety and efficacy of ASA in recurrent MD, as well as assessing the linkage of ASA treatment with inflammatory phenotype and cytokines, are required. There is also a need for preclinical studies to understand the exact mechanism of action of ASA in MD.

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Section: Discussionmentioning

confidence: 99%

Acetylsalicylic Acid and Mood Disorders: A Systematic Review

Dominiak

Gędek²,

Sikorska

et al. 2022

Pharmaceuticals

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“…This population-based cohort addresses limitations observed in clinical series, with referral bias, and lack of complete case ascertainment in administrative data bases. Previous studies on schizophrenia and bipolar disorder have been performed using REP, offering long-term perspectives of cohorts with confirmed psychiatric disorders (23)(24)(25)(26).…”

Section: Data Source and Study Populationmentioning

confidence: 99%

Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study

Gardea-Resendez,

Ortiz-Orendain,

Miola

et al. 2023

Front. Psychiatry

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BackgroundThere is evidence suggesting racial disparities in diagnosis and treatment in bipolar disorder (BD) and schizophrenia (SZ). The purpose of this study is to compare psychiatric diagnoses and psychotropic use preceding a first episode of mania (FEM) or psychosis (FEP) in racially diverse patients.MethodsUsing a comprehensive medical records linkage system (Rochester Epidemiology Project, REP), we retrospectively identified individuals diagnosed with BD or SZ and a documented first episode of mania or psychosis. Illness trajectory before FEP/FEM were characterized as the time from first visit for a mental health complaint to incident case. Pathways to care and clinical events preceding FEP/FEM were compared based on subsequent incident case diagnosis (BD or SZ) and self-reported race (White vs. non-White).ResultsA total of 205 (FEM = 74; FEP = 131) incident cases were identified in the REP. Duration of psychiatric antecedents was significantly shorter in non-White patients, compared to White patients (2.2 ± 4.3 vs. 7.4 ± 6.6 years; p < 0.001) with an older age at time of first visit for a mental health complaint (15.7 ± 6.3 vs. 11.1 ± 6.0 years; p = 0.005). There were no significant differences by race in FEM pathway to care or age of first seeking mental health. Overall non-White patients had lower rates of psychotropic use.ConclusionThese data are unable to ascertain reasons for shorter duration of psychiatric antecedents and later age of seeking care, and more broadly first age of initial symptom presentation. If symptoms are confirmed to be earlier than first time seeking care in both groups, it would be important to identify barriers that racial minorities face to access timely psychiatric care and optimize early intervention strategies.

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“…Multiple physical comorbidities occur at a higher rate in bipolar disorder, including -but not limited to -obesity, type 2 diabetes mellitus, metabolic syndrome, cardiovascular disease, thyroid dysfunction, and inflammatory bowel disease [255][256][257] . Moreover, there is increasing awareness of the higher rate of non-alcoholic fatty liver disease in persons with bipolar disorder, which is associated with obesity, exposure to psychotropic medication, and number of prior mood episodes 258 .…”

Section: Physical Comorbiditiesmentioning

confidence: 99%

The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management

et al. 2022

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Bipolar disorder is heterogeneous in phenomenology, illness trajectory, and response to treatment. Despite evidence for the efficacy of multimodal ity interventions, the majority of persons affected by this disorder do not achieve and sustain full syndromal recovery. It is eagerly anticipated that combining datasets across various information sources (e.g., hierarchical "multiomic" measures, electronic health records), analyzed using ad vanced computational methods (e.g., machine learning), will inform future diagnosis and treatment selection. In the interim, identifying clinically meaningful subgroups of persons with the disorder having differential response to specific treatments at pointofcare is an empirical priority. This paper endeavours to synthesize salient domains in the clinical characterization of the adult patient with bipolar disorder, with the overarching aim to improve health outcomes by informing patient management and treatment considerations. Extant data indicate that characterizing select domains in bipolar disorder provides actionable information and guides shared decision making. For example, it is robustly established that the presence of mixed features -especially during depressive episodes -and of physical and psychiatric comorbidities informs illness trajectory, response to treatment, and suicide risk. In addition, early environmental exposures (e.g., sexual and physical abuse, emotional neglect) are highly associated with more complicated illness presentations, inviting the need for developmentallyoriented and integrated treatment approaches. There have been significant advances in validating subtypes of bipolar disorder (e.g., bipolar I vs. II disorder), particularly in regard to pharmacological interventions. As with other severe mental disorders, social functioning, interpersonal/family relationships and internalized stigma are domains highly relevant to relapse risk, health outcomes, and quality of life. The elevated standardized mortality ratio for completed suicide and suicidal behaviour in bipolar disorder invites the need for characterization of this domain in all patients. The framework of this paper is to describe all the above salient domains, provid ing a synthesis of extant literature and recommendations for decision support tools and clinical metrics that can be implemented at pointofcare.

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Association of Bipolar Disorder With Major Adverse Cardiovascular Events: A Population-Based Historical Cohort Study

Cited by 16 publications

References 52 publications

Acetylsalicylic Acid and Mood Disorders: A Systematic Review

Acetylsalicylic Acid and Mood Disorders: A Systematic Review

Racial differences in pathways to care preceding first episode mania or psychosis: a historical cohort prodromal study

The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management

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