Better understanding of c-reactive protein and leukocytes in psychiatric inpatients with affective disorders:A biopsychosocial approach

BACKGROUND Affective disorders(AD)have been linked to inflammatory processes,although the underlying mechanisms of this relationship are still not fully elucidated.It is hypothesized that demographic,somatic,lifestyle,and personality variables predict inflammatory parameters in AD.AIM To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters,C-reactive protein(CRP)and leukocytes.METHODS This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters,serum inflammatory markers,somatic variables,psychological questionnaires,and lifestyle parameters.Hierarchical regression analyses were used to predict inflammatory markers from demographic,somatic,lifestyle,and personality variables.RESULTS Analyses showed that 33.8%of the variance of CRP was explained by body mass index and other somatic medication(e.g.anti-diabetics),age and education,and age of affective disorder diagnosis.For leukocytes,20.1%of the variance was explained by smoking,diet,metabolic syndrome(MetS),and anti-inflammatory medication(e.g.non-steroidal anti-inflammatory drugs).Other psychiatric or behavioural variables did not reach significance.CONCLUSION Metabolic components seem important,with mounting evidence for a metabolic affective disorder subtype.Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.

Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic is having a great impact on individuals from all over the world,particularly on individuals with mental disorders.Several studies found more pronounced psychiatric symptoms,notably symptoms of depression and anxiety.AIM To assess the situation of patients with serious mental illness(SMI:Affective disorders and schizophrenia)regarding their mental health outcome during the pandemic.METHODS A systematic search using the databases PubMed and MEDLINE was conducted,employing the key words“COVID-19”,“SARS-CoV-2”,“psychiatric/mental disorder/illness”,“affective/mood disorder”,“bipolar disorder”,“(major)depression”,“schizoaffective disorder”,and“schizophrenia”.Studies that had been published up until January 9,2021 were included.Information of studies in languages other than English and German was mostly taken from their English abstracts.RESULTS The literature search concluded in the finding of 36 studies containing relevant clinical data.A general impairment of the mental health of individuals with SMI could be detected,particularly in individuals with affective disorders,as compared to those with schizophrenia.Compared to healthy controls,symptoms of anxiety,depression,and stress were more pronounced in individuals with SMI.Relevant factors found that impacted their mental health were age,resilience,and socioeconomic environment,especially the shortage of mental health services,lack of social support,and inadequate information about COVID-19.CONCLUSION In light of these results,mental health services should be reinforced,notably the use of telemental health services.Furthermore,supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is important.When researching the impact of the COVID-19 pandemic on individuals with SMI,standardization as well as follow-up studies are needed to enable better comparability and understanding.

Believing processes during the COVID-19 pandemic in individuals with bipolar disorder:An exploratory study

BACKGROUND Believing or“credition”refers to psychological processes that integrate the cognitions and emotions that influence our behavior.In the credition model by Angel and Seitz,four parameters are postulated:proposition,certainty,emotion and mightiness.It is assumed that believing processes are influenced by both the individual as well as socio-cultural factors and external circumstances.External or environmental circumstances can include threatening situations such as the ongoing pandemic.It has been hypothesized that believing processes related to the pandemic differ between individuals with bipolar disorder(BD)and healthy controls(HC).AIM To investigate credition in individuals with BD during the coronavirus disease 2019(COVID-19)pandemic.METHODS Psychiatrically stable individuals with BD(n=52)and age-and sex matched HC(n=52)participated in an online survey during the first lockdown of the COVID-19 pandemic.The survey took place between April 9^(th) and June 4^(th),2020,in Austria.Participants completed the Brief Symptom Inventory-18,the Beck Depression Inventory-Ⅱ,the Altman Self-Rating Mania Scale,the Pittsburgh Sleep Quality Index and a dedicated Believing Questionnaire assessing four parameters of credition(proposition,certainty,emotion and mightiness).The MAXQDA software was used to analyze the qualitative data.Statistical analyses included analyses of variance,a multivariate analysis of variance and a multivariate analysis of co-variance.RESULTS Individuals with BD reported significantly more negative propositions[F(1,102)=8.89,P=0.004,η2 p=0.08]and negative emotions[Welch´s F(1,82.46)=18.23,P<0.001,η2 p=0.18],while HC showed significantly more positive propositions[F(1,102)=7.78,P=0.006,η2 p=0.07]and emotions[F(1,102)=14.31,P<0.001,η2 p=0.12].In addition,individuals with BD showed a higher incongruence between their propositions and their emotions[F(1,102)=9.42,P=0.003,η2 p=0.08]and showed strong correlations between the parameters of the Believing Questionnaire and their psychiatric symptoms(r=0.51-0.77,all P<0.001).Positive as well as negative emotions and propositions were associated with scores measuring symptoms of depression,anxiety and sleep quality.CONCLUSION Believing parameters were associated with psychiatric symptoms in BD during the pandemic.Findings broaden knowledge about the susceptibility of believing processes for ambient challenges in individuals with BD.