A A Dargél1,2, F Roussel3, S Volant4, B Etain5,6, R Grant7, J-M Azorin5,8, K M'Bailara5,9, F Bellivier5,6, T Bougerol5,10, J-P Kahn5,11, P Roux5,12,13, V Aubin5,14, P Courtet5,15, M Leboyer5,16,17, F Kapczinski18, C Henry1,5,16,17. 1. Institut Pasteur, Unité Perception et Mémoire, Paris, France. 2. Centre National de la Recherche Scientifique, Unité Mixte de Recherche 3571, Paris, France. 3. Centre de Recherche Interdisciplinaire (CRI), Paris, France. 4. Institut Pasteur, Bioinformatics and Biostatistics Hub (C3BI), USR 3756 IP CNRS, Paris, France. 5. Fondation FondaMental, Fondation de Cooperation Scientifique, Créteil, France. 6. AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences Tête et Cou, INSERM UMRS 1144, University Paris Diderot, Paris, France. 7. Centre for Global Health, Institut Pasteur, Paris, France. 8. Département de Psychiatrie, Hôpital Sainte-Marguerite, Marseille, France. 9. Laboratoire de Psychologie, EA 4139, Centre Expert Troubles Bipolaires, Pôle 3-4-7, Hôpital Charles Perrens, Université Bordeaux, Bordeaux, France. 10. Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 836, Grenoble, France. 11. Centre Hospitalier Universitaire de Nancy - Hôpitaux de Brabois, Université de Lorraine, Nancy, France. 12. Department of Adult Psychiatry, Versailles Hospital, Le Chesnay, France. 13. EA4047, University of Versailles Saint-Quentin-En-Yvelines, Montigny-le-Bretonneux, France. 14. Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France. 15. Department of Emergency Psychiatry and Acute Care, CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France. 16. AP-HP, Pôle de psychiatrie, Hôpital H. Mondor - A. Chenevier, Créteil, France. 17. INSERM, U955, Université Paris-Est, Créteil, France. 18. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Abstract
OBJECTIVE: Remitted bipolar disorder (BD) patients frequently present with chronic mood instability and emotional hyper-reactivity, associated with poor psychosocial functioning and low-grade inflammation. We investigated emotional hyper-reactivity as a dimension for characterization of remitted BD patients, and clinical and biological factors for identifying those with and without emotional hyper-reactivity. METHOD: A total of 635 adult remitted BD patients, evaluated in the French Network of Bipolar Expert Centers from 2010-2015, were assessed for emotional reactivity using the Multidimensional Assessment of Thymic States. Machine learning algorithms were used on clinical and biological variables to enhance characterization of patients. RESULTS: After adjustment, patients with emotional hyper-reactivity (n = 306) had significantly higher levels of systolic and diastolic blood pressure (P < 1.0 × 10-8 ), high-sensitivity C-reactive protein (P < 1.0 × 10-8 ), fasting glucose (P < 2.23 × 10-6 ), glycated hemoglobin (P = 0.0008) and suicide attempts (P = 1.4 × 10-8 ). Using models of combined clinical and biological factors for distinguishing BD patients with and without emotional hyper-reactivity, the strongest predictors were: systolic and diastolic blood pressure, fasting glucose, C-reactive protein and number of suicide attempts. This predictive model identified patients with emotional hyper-reactivity with 84.9% accuracy. CONCLUSION: The assessment of emotional hyper-reactivity in remitted BD patients is clinically relevant, particularly for identifying those at higher risk of cardiometabolic dysfunction, chronic inflammation, and suicide.
OBJECTIVE:Remitted bipolar disorder (BD) patients frequently present with chronic mood instability and emotional hyper-reactivity, associated with poor psychosocial functioning and low-grade inflammation. We investigated emotional hyper-reactivity as a dimension for characterization of remitted BDpatients, and clinical and biological factors for identifying those with and without emotional hyper-reactivity. METHOD: A total of 635 adult remitted BDpatients, evaluated in the French Network of Bipolar Expert Centers from 2010-2015, were assessed for emotional reactivity using the Multidimensional Assessment of Thymic States. Machine learning algorithms were used on clinical and biological variables to enhance characterization of patients. RESULTS: After adjustment, patients with emotional hyper-reactivity (n = 306) had significantly higher levels of systolic and diastolic blood pressure (P < 1.0 × 10-8 ), high-sensitivity C-reactive protein (P < 1.0 × 10-8 ), fasting glucose (P < 2.23 × 10-6 ), glycated hemoglobin (P = 0.0008) and suicide attempts (P = 1.4 × 10-8 ). Using models of combined clinical and biological factors for distinguishing BDpatients with and without emotional hyper-reactivity, the strongest predictors were: systolic and diastolic blood pressure, fasting glucose, C-reactive protein and number of suicide attempts. This predictive model identified patients with emotional hyper-reactivity with 84.9% accuracy. CONCLUSION: The assessment of emotional hyper-reactivity in remitted BDpatients is clinically relevant, particularly for identifying those at higher risk of cardiometabolic dysfunction, chronic inflammation, and suicide.
Authors: Thomas D Bjella; Margrethe Collier Høegh; Stine Holmstul Olsen; Sofie R Aminoff; Elizabeth Barrett; Torill Ueland; Romain Icick; Ole A Andreassen; Mari Nerhus; Henrik Myhre Ihler; Marthe Hagen; Cecilie Busch-Christensen; Ingrid Melle; Trine Vik Lagerberg Journal: Front Med Technol Date: 2022-07-22