Bipolar4LifeSupport

A study published in the American Journal of Psychiatry suggests an association between smoking during pregnancy and increased risk for developing bipolar disorder (BD) in adult children. Researchers at the New York State Psychiatric Institute and the Department of Epidemiology at the Mailman School of Public Health at Columbia University, in collaboration with scientists at the Kaiser Permanente Division of Research in Oakland, California, evaluated offspring from a large cohort of pregnant women who participated in the Child Health and Development Study (CHDS) from 1959-1966. The study was based on 79 cases and 654 comparison subjects. Maternal smoking during pregnancy was associated with a twofold increased risk of BD in their offspring.

Smoking during pregnancy is known to contribute to significant problems in utero and following birth, including low birth weight and attentional difficulties. This is the first study to suggest an association between prenatal tobacco exposure and BD, a serious psychiatric illness marked by significant shifts in mood that alternate between periods of depression and mania. Symptoms typically become noticeable in the late teens or early adulthood.

“These findings underscore the value of ongoing public health education on the potentially debilitating, and largely preventable, consequences that smoking may have on children over time,” said Alan Brown, MD, MPH, senior author and Professor of Clinical Psychiatry and Epidemiology at the New York State Psychiatric Institute, Columbia University and Mailman School of Public Health.

The authors wrote: “Much of the psychopathology associated with prenatal tobacco exposure clusters around the ‘externalizing’ spectrum, which includes attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and substance abuse disorders. Although not diagnostically classified along the externalizing spectrum, BD shares a number of clinical characteristics with these disorders, including inattention, irritability, loss of self-control, and proclivity to drug/alcohol use.” In effect, children who were exposed to tobacco smoke in utero may exhibit some symptoms and behaviors that are found in BD.

A previous study by Dr. Brown and colleagues found that flu virus in pregnant mothers was associated with a fourfold increased risk that their child would develop BD.

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A study published in the October 2013 issue of the Journal of the American Academy of Child and Adolescent Psychiatry found that approximately one in three teens with bipolar disorder developed substance abuse, for the first time, during 4 years of follow-up. The study also identified several risk factors that predicted who among these teens was most likely to develop substance abuse.

Using data from the Course and Outcome of Bipolar Youth (COBY) study, a group of researchers led by Dr. Benjamin Goldstein, of the University of Toronto and the University of Pittsburgh, examined 167 youth, ages 12-17 years, to document the frequency and possible predictors of first-onset substance abuse. Participants in the study were interviewed an average of 7 times over the course of 4 years in order to examine their symptoms, functioning, stressors, and treatment.

The study found that 32% of adolescents in COBY developed abuse or dependence of alcohol or drugs, on average 2.7 years from the start of the study. Repeated experimentation with alcohol at the start of the study was the single strongest predictor of later substance abuse, although experimentation with cannabis also predicted later substance abuse. Five other factors present at the start of the study also predicted later substance abuse: oppositional defiant disorder, panic disorder, family history of substance abuse, low family cohesiveness, and absence of antidepressant treatment. Among teens with 3 or more risk factors, 54.7% went on to develop substance abuse, compared to 14.1% of teens with 0-2 risk factors.

The COBY study, funded by the National Institute of Mental Health, is the largest longitudinal study of children and adolescents with bipolar disorder. The 3-site study enrolled participants at Brown University, UCLA, and the University of Pittsburgh. COBY is continuing to follow these adolescents into their twenties and thirties.

Dr. Goldstein highlighted the risk associated with experimental substance use “in the case of adolescents with bipolar disorder, even so-called recreational substance use is playing with fire.” He concluded “we appear to have this window of 2-3 years during which we can attempt to prevent substance abuse in these youth. This study provides some clues regarding the types of preventive strategies that may be useful.”

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Investigators at The Feinstein Institute for Medical Research have discovered a new genetic risk factor for schizophrenia and bipolar disorder called NDST3. The findings are published online in Nature Communications.

The study, by a team lead by Todd Lencz, PhD, associate investigator at the Zucker Hillside Hospital Department of Psychiatry Research and Feinstein Institute, studied more than 25,000 individuals. In collaboration with Ariel Darvasi, PhD, of the Hebrew University of Jerusalem, Dr. Lencz has been working with a set of DNA samples from patients with schizophrenia and healthy volunteers drawn from the Ashkenazi Jewish population. The Ashkenazi Jewish population represents a unique population for study because of its short (less than 1,000-year) history and limited population. This history results in a more uniform genetic background in which to identify disease-related variants.

“This study again demonstrates the value of our Ashkenazi cohort,” said Dr. Lencz. “It is notable that the genetic variant was replicated in samples of various ethnicities from all around the world, but the effects were strongest in the Ashkenazi cohort, presumably due to their unique genetic history.”

Dr. Lencz’s team reported that the genetic variant, which changes a single “letter” of the DNA code, alters the expression of the gene NDST3. This gene is critical to neurodevelopmental processes such as axon formation and synaptic function. These findings shed new light on the genetic architecture and potential therapeutic targets for the treatment of psychiatric disease.

Schizophrenia and bipolar disorder are severe psychiatric disorders that affect 1-4 percent of the global population. Studies have shown that the two disorders are likely to have a large overlap in genetic risk factors, but only a small portion of this genetic risk has been identified.

This work was supported by a grant from the National Institute of Mental Health (NIMH), funded as part of the American Recovery and Reinvestment Act of 2009 (also known as the economic stimulus plan). More recently, the work by Drs. Lencz and Darvasi with the Ashkenazi schizophrenia cohort has received an additional $3 million from the NIMH, as well as grants from the Brain & Behavior Foundation and the Binational Science Foundation.

Dr. Lencz is also the co-leader of The Ashkenazi Genomics Consortium, a collaborative effort involving more than a dozen investigators from leading institutions (including Columbia University, Mt. Sinai School of Medicine, Albert Einstein College of Medicine and MIT), using similar strategies to understand the genetic basis of diseases including cancer, diabetes, and Parkinson’s.

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The use of antidepressants in the treatment of bipolar disorder remains controversial. Some studies and treatment guidelines suggest that antidepressant treatment for bipolar disorder may have the potential to increase the manic switch, while others recommend short-term antidepressant treatment and early discontinuation. A recent study by Dr. Yingli Zhang and co-workers from Mental Health Institute of Central South University in China involved new large-sample double-blind randomized controlled trials, excluded open-label design studies, and supplemented studies involving homogeneous patients. Suicidality firstly served as an important outcome, strict inclusion criteria included limitation to double-blind randomized controlled studies and interventional treatment without use of antipsychotics to make the study results more objective and convincing. The results from this study do not support that antidepressants are more effective in the treatment of bipolar disorder. Antidepressants are not superior to placebo and other medication in short-term, and long-term use of antidepressants cannot achieve higher response and remission rates of bipolar disorder. These findings, published in the Neural Regeneration Research (Vol. 8, No. 31, 2013), guide future clinical studies and provide evidence for preparing treatment strategy for bipolar disorder.

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Famous people with bipolar disorder

Below is a list of some famous people who suffer or suffered from bipolar disorder:
◾Adam Ant, British musician
◾Amy Winehouse, British musician
◾Axl Rose, lead singer for Guns N’ Roses
◾Catherine Zeta-Jones, British (Welsh) actress
◾Edgar Allan Poe, British poet and writer (most likely had bipolar disorder)
◾Edward Elgar, British composer
◾Florence Nightingale, British nurse and health campaigner
◾Frank Bruno, boxer
◾Frank Sinatra, American singer and actor
◾Graham Greene, British novelist
◾Jack Irons, drummer, formerly of Red Hot Chili Peppers
◾Jack London, American author
◾Jean-Claude Van Damme, Belgian actor
◾Ludwig van Beethoven, German composer and pianist (possibly have had bipolar disorder)
◾Maria Bamford, American comedian
◾Mel Gibson, Australian actor and director
◾Rep. Patrick J. Kennedy, American politician
◾Richard Dreyfuss, actor
◾Robert Downey, Jr., actor
◾Sting, British musician
◾Sidney Sheldon, American producer, writer
◾Sinéad O’Connor, Irish musician
◾Spike Milligan, Irish comedian
◾Stephen Fry, British actor, comedian and writer
◾Vincent Crane, keyboard player of Atomic Rooster
◾Vincent Van Gogh, Dutch artist (possibly had bipolar disorder; there are various hypotheses)
◾Virginia Woolf, British writer
◾Vivien Leigh, British actress.

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