Thomas Bjella

• Glastad, Stine Holmstul; Klungsøyr, Ole; Aminoff, Sofie Ragnhild; Hagen, Roger; Bjella, Thomas & Engen, Magnus Johan [Show all 11 contributors for this article] (2026). Frequency analysis of mood, sleep, and alcohol and nicotine use: investigating instability in bipolar I and II disorder. Frontiers in Psychiatry. 17, p. 1–12. doi: 10.3389/fpsyt.2026.1810743.
• Busch, Cecilie; Ueland, Torill; Høegh, Margrethe Collier; Simonsen, Carmen; Aminoff, Sofie R. & Barrett, Elizabeth Ann [Show all 11 contributors for this article] (2026). Wish list from people with lived experience of bipolar disorder - for clinicians and researchers. Journal of Affective Disorders Reports. 25, p. 101114–101114. doi: 10.1016/j.jadr.2026.101114. Full text in Research Archive
• Bauer, M.; Glenn, T.; Achtyes, E. D.; Alda, M.; Agaoglu, E. & Altınbaş, K. [Show all 164 contributors for this article] (2026). Family History and Solar Insolation in Bipolar I Disorder. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 153(4), p. 270–278. doi: 10.1111/acps.70075. Full text in Research Archive
• Høegh, Margrethe Collier; Glastad, Stine Holmstul; Lyngstad, Siv Hege; Engen, Magnus Johan; Aminoff, Sofie Ragnhild & Melle, Ingrid [Show all 8 contributors for this article] (2025). The MinDag app for symptom monitoring and feedback to patients and clinicians during the initial treatment of bipolar disorder – a feasibility study. International journal of bipolar disorders. 13(1). doi: 10.1186/s40345-025-00382-x. Full text in Research Archive Show summary

  Background The app “MinDag” (MyDay) was developed as a tool for monitoring mood, symptoms and illness-relevant behaviour in the initial treatment of bipolar disorder. Digital self-monitoring may provide patients and clinicians with valuable data for tailoring treatment interventions. This study aims to evaluate the practical use and clinical implications of integrating MinDag in the early treatment of bipolar disorder from the perspectives of both patients and clinicians. Methods The MinDag app includes six content modules covering mood, sleep, functioning/activities, substance use, emotional reactivity, and psychotic symptoms. Patients were asked to use the app for six months, and automated feedback based on the app registrations was delivered to the patients’ clinicians biweekly. The study involved quantitative evaluations completed by patients (n = 20), as well as interviews with patients (n = 7) and clinicians (n = 2). Results Overall, the patients reported that they felt that MinDag was safe, relevant and easy to use, although technical difficulties such as too many automated reminders and need for reinstallations were reported. The patients appreciated the potential for increased awareness of their mental health, but expressed a desire for direct access to their data. Clinicians found the visual reports and feedback useful for tailoring treatment, even though the alert system for high-risk variables needed refinement. The quantitative evaluations indicated a positive general reception, with suggestions for improvement in usability and accessibility. Conclusion The MinDag app shows promise as a tool for enhancing the treatment of bipolar disorder by facilitating self-monitoring and providing actionable data to clinicians. However, technical issues and the need for direct patient access to data must be addressed. Development of digital tools to support the treatment of bipolar disorder and other mental health conditions is resource demanding, and there is a need to clarify criteria to establish proof of concept to guide the selection of tools for upscaling and implementation.

• Glastad, Stine Holmstul; Klungsøyr, Ole; Aminoff, Sofie Ragnhild; Hagen, Roger; Bjella, Thomas & Engen, Magnus Johan [Show all 14 contributors for this article] (2025). Exploring the temporal relationship between mood, alcohol- and nicotine use in bipolar disorder using time-series analyses. International journal of bipolar disorders. 13(1). doi: 10.1186/s40345-025-00388-5. Full text in Research Archive Show summary

  Background The prevalence of substance use disorders in bipolar disorder (BD) is high. Exploring potential interactions between mood and the use of common substances such as alcohol and nicotine may contribute to a better understanding of the mechanisms underlying such comorbidities. Digital tools now allow for continuous monitoring and data collection of both symptoms and behavior. This enables time-series analyses to explore such associations with greater precision. Methods Thirty-two individuals in the early phases of BD registered their mood daily and their use of substances weekly in the MinDag (MyDay) app for up to 6 months. We explored temporal relationships between the use of alcohol and nicotine and the levels of depressed, elevated, irritable, and anxious mood using Vector Autoregressive Models and Granger causality tests. Results We found indications that mood influenced alcohol- and nicotine use, and vice versa. Significant temporal relationships (Granger causality) were found in 55% (11 out of 20) of the participants for alcohol and 70% (7 out of 10) for nicotine use, and with high proportions of the variance explained by the one time-series on the other. The associations were consistent with causal effects in one or both directions, but with no adjustment for confounding. Conclusion Our findings indicate that mood influences alcohol- and nicotine use and vice versa in individuals with BD, although caution should be taken due to the exploratory approach. Larger samples are needed to further disentangle these relationships to provide insight for better prevention and treatment of BD and comorbid substance use disorders.

• Romm, Kristin Lie; Skoge, Mari; Barrett, Elizabeth Ann; Berentzen, Lars-Christian; Bergsager, Dagfinn & Fugeli, Pål [Show all 18 contributors for this article] (2025). A Mobile Health Intervention to Support Collaborative Decision-Making in Mental Health Care: Development and Usability. JMIR Formative Research. 9. doi: 10.2196/57614. Full text in Research Archive
• Simonsen, Carmen; Åsbø, Gina; Slade, Michael; Wold, Kristin Fjelnseth; Widing, Line Hustad & Flaaten, Camilla Bärthel [Show all 13 contributors for this article] (2024). A good life with psychosis: Rate of positive outcomes in first-episode psychosis at 10-year follow-up. Psychological Medicine. ISSN 0033-2917. 54(9), p. 2112–2121. doi: 10.1017/S0033291724000205. Full text in Research Archive Show summary

  Background More knowledge about positive outcomes for people with first-episode psychosis (FEP) is needed. An FEP 10-year follow-up study investigated the rate of personal recovery, emotional wellbeing, and clinical recovery in the total sample and between psychotic bipolar spectrum disorders (BD) and schizophrenia spectrum disorders (SZ); and how these positive outcomes overlap. Methods FEP participants (n = 128) were re-assessed with structured clinical interviews at 10-year follow-up. Personal recovery was self-rated with the Questionnaire about the Process of Recovery-15-item scale (total score ⩾45). Emotional wellbeing was self-rated with the Life Satisfaction Scale (score ⩾5) and the Temporal Experience of Pleasure Scale (total score ⩾72). Clinical recovery was clinician-rated symptom-remission and adequate functioning (duration minimum 1 year). Results In FEP, rates of personal recovery (50.8%), life satisfaction (60.9%), and pleasure (57.5%) were higher than clinical recovery (33.6%). Despite lower rates of clinical recovery in SZ compared to BD, they had equal rates of personal recovery and emotional wellbeing. Personal recovery overlapped more with emotional wellbeing than with clinical recovery (χ2). Each participant was assigned to one of eight possible outcome groups depending on the combination of positive outcomes fulfilled. The eight groups collapsed into three equal-sized main outcome groups: 33.6% clinical recovery with personal recovery and/or emotional wellbeing; 34.4% personal recovery and/or emotional wellbeing only; and 32.0% none. Conclusions In FEP, 68% had minimum one positive outcome after 10 years, suggesting a good life with psychosis. This knowledge must be shared to instill hope and underlines that subjective and objective positive outcomes must be assessed and targeted in treatment.

• Ritter, Philipp; Glenn, Tasha; Achtyes, Eric D.; Alda, Martin; Agaoglu, Esen & Altınbaş, Kürsat [Show all 166 contributors for this article] (2024). Association between a large change between the minimum and maximum monthly values of solar insolation and a history of suicide attempts in bipolar I disorder. International journal of bipolar disorders. 12(1). doi: 10.1186/s40345-024-00364-5. Full text in Research Archive Show summary

  Background The rate of suicide attempts by patients with bipolar disorder is high. In addition to patient and coun‑ try specifc factors, environmental factors may contribute to suicidal behavior. Sunlight has multiple diverse impacts on human physiology and behavior. Solar insolation is defned as the electromagnetic energy from the sun striking a surface area on earth. We previously found that a large change in solar insolation between the minimum and maxi‑ mum monthly values was associated with an increased risk of suicide attempts in patients with bipolar I disorder. Methods The association between solar insolation and a history of suicide attempts in bipolar disorder was again investigated using an international database with 15% more data and more sites at diverse locations and countries. Results Data were available from 5641 patients with bipolar I disorder living at a wide range of latitudes in 41 coun‑ tries in both hemispheres. A large change in solar insolation between the minimum and maximum monthly values was associated with a history of suicide attempts in patients with bipolar I disorder, a replication of our prior analysis. The estimated model also associated state sponsored religion in the onset country, female gender, a history of alcohol or substance abuse, and being part of a younger birth cohort with a history of suicide attempts. Conclusions A large change between the minimum and maximum monthly values of solar insolation was associ‑ ated with a history of suicide attempts in bipolar I disorder, replicating our prior research. Physicians should be aware that daylight has wide ranging physiological and psychiatric impacts, and that living with large changes in solar inso‑ lation may be associated with an increased suicide risk.

• Dur, Dur E Shahnaz; Jørgensen, Kjetil Nordbø; Bjella, Thomas; Nesvåg, Ragnar; Dieset, Ingrid & Melle, Ingrid [Show all 8 contributors for this article] (2024). Prescriptions of psychotropic and somatic medications among patients with severe mental disorders and healthy controls in a naturalistic study. Nordic Journal of Psychiatry. ISSN 0803-9488. 78(3), p. 212–219. doi: 10.1080/08039488.2024.2305806. Full text in Research Archive Show summary

  Purpose Psychotropic and somatic medications are both used in treating severe mental disorders (SMDs). Realistic estimates of the prevalence of use across medication categories are needed. We obtained this in a clinical cohort of patients with SMD and healthy controls (HCs). Materials and methods Prescriptions filled at Norwegian pharmacies the year before and after admittance to the Thematically Organized Psychosis (TOP) study were examined in 1406 patients with SMD (mean age 32.5 years, 48.2% women) and 920 HC (34.1 years, 46.2% women). Using data from the Norwegian Prescription Database (NorPD), the number of users in different anatomical therapeutic chemical (ATC) categories was compared using logistic regression. Population estimates were used as reference data. Results Use of antipsychotics (N05A), antiepileptics (N03A), antidepressants (N06A), anxiolytics (N05B), hypnotics and sedatives (N05C), anticholinergics (N04A), psychostimulants, attention deficit hyperactivity disorder and nootropic agents (N06B) and drugs for addiction disorders (N07B) was significantly more prevalent in patients with SMD than HC. Use of diabetes treatment (A10), antithrombotic drugs (B01), beta blockers (C07), lipid modifiers (C10), and thyroid and endocrine therapeutics (H03) was also more prevalent in patients with SMD, but with two exceptions somatic medication use was comparable to the general population. Among HC, there was low prevalence of use for most medication categories. Conclusion Patients were using psychiatric medications, but also several types of somatic medications, more often than HC. Still, somatic medication use was mostly not higher than in the general population. The results indicate that HC had low use of most medication types.

• Wootton, Olivia; Shadrin, Alexey; Bjella, Thomas; Smeland, Olav Bjerkehagen; Meer, Dennis van der & Frei, Oleksandr [Show all 11 contributors for this article] (2024). Genomic insights into the shared and distinct genetic architecture of cognitive function and schizophrenia. Scientific Reports. 14(1). doi: 10.1038/s41598-024-66085-y. Full text in Research Archive Show summary

  Cognitive impairment is a major determinant of functional outcomes in schizophrenia, however, understanding of the biological mechanisms underpinning cognitive dysfunction in the disorder remains incomplete. Here, we apply Genomic Structural Equation Modelling to identify latent cognitive factors capturing genetic liabilities to 12 cognitive traits measured in the UK Biobank. We identified three broad factors that underly the genetic correlations between the cognitive tests. We explore the overlap between latent cognitive factors, schizophrenia, and schizophrenia symptom dimensions using a complementary set of statistical approaches, applied to data from the latest schizophrenia genome-wide association study (Ncase = 53,386, Ncontrol = 77,258) and the Thematically Organised Psychosis study (Ncase = 306, Ncontrol = 1060). Global genetic correlations showed a significant moderate negative genetic correlation between each cognitive factor and schizophrenia. Local genetic correlations implicated unique genomic regions underlying the overlap between schizophrenia and each cognitive factor. We found substantial polygenic overlap between each cognitive factor and schizophrenia and biological annotation of the shared loci implicated gene-sets related to neurodevelopment and neuronal function. Lastly, we show that the common genetic determinants of the latent cognitive factors are not predictive of schizophrenia symptoms in the Norwegian Thematically Organized Psychosis cohort. Overall, these findings inform our understanding of cognitive function in schizophrenia by demonstrating important differences in the shared genetic architecture of schizophrenia and cognitive abilities.

• Bauer, Michael; Glenn, Tasha; Achtyes, Eric D.; Alda, Martin; Agaoglu, Esen & Altınbaş, Kürsat [Show all 162 contributors for this article] (2023). Exploratory study of ultraviolet B (UVB) radiation and age of onset of bipolar disorder. International journal of bipolar disorders. 11(1). doi: 10.1186/s40345-023-00303-w. Full text in Research Archive Show summary

  Background Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. Methods Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. Results The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. Conclusion UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.

• Widing, Line Hustad; Simonsen, Carmen; Bjella, Thomas; Engen, Magnus Johan; Flaaten, Camilla Bärthel & Gardsjord, Erlend Strand [Show all 15 contributors for this article] (2023). Long-term Outcomes of People With DSM Psychotic Disorder NOS. Schizophrenia Bulletin Open. 4(1). doi: 10.1093/schizbullopen/sgad005. Full text in Research Archive Show summary

  Introduction: The Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnostic category “Psychotic disorder not otherwise specified” (PNOS) is seldom investigated, and we lack knowledge about longterm outcomes. We examined long-term symptom severity, global functioning, remission/recovery rates, and diagnostic stability after the first treatment for PNOS. Methods: Participants with first-treatment PNOS (n = 32) were reassessed with structured interviews after 7 to 10 years. The sample also included narrow schizophrenia spectrum disorders (SSD, n = 94) and psychotic bipolar disorders (PBD, n = 54). Symptomatic remission was defined based on the Remission in Schizophrenia Working Group criteria. Clinical recovery was defined as meeting the criteria for symptomatic remission and having adequate functioning for the last 12 months. Results: Participants with baseline PNOS or PBD had lower symptom severity and better global functioning at follow-up than those with SSD. More participants with PNOS and PBD were in symptomatic remission and clinical recovery compared to participants with SSD. Seventeen (53%) PNOS participants retained the diagnosis, while 15 participants were diagnosed with either SSD (22%), affective disorders (19%), or substanceinduced psychotic disorders (6%). Those rediagnosed with SSD did not differ from the other PNOS participants regarding baseline clinical characteristics. Conclusions: Long-term outcomes are more favorable in PNOS and PBD than in SSD. Our findings confirm diagnostic instability but also stability for a subgroup of participants with PNOS. However, it is challenging to predict diagnostic outcomes of PNOS based on clinical characteristics at first treatment.

• Hindley, Guy Frederick Lanyon; Shadrin, Alexey; Meer, Dennis van der; Parker, Nadine; Cheng, Weiqiu & O'Connell, Kevin Sean [Show all 23 contributors for this article] (2023). Multivariate genetic analysis of personality and cognitive traits reveals abundant pleiotropy. Nature Human Behaviour. 7, p. 1584–1600. doi: 10.1038/s41562-023-01630-9. Full text in Research Archive
• Villar, Jonelle Marie Dickow; Stavrum, Anne-Kristin Støbakk; Spindola, Leticia Maria Nery; Torsvik, Anja; Bjella, Thomas & Steen, Nils Eiel [Show all 10 contributors for this article] (2023). Differences in white blood cell proportions between schizophrenia cases and controls are influenced by medication and variations in time of day. Translational Psychiatry. 13(1). doi: 10.1038/s41398-023-02507-1. Full text in Research Archive Show summary

  Cases with schizophrenia (SCZ) and healthy controls show differences in white blood cell (WBC) counts and blood inflammation markers. Here, we investigate whether time of blood draw and treatment with psychiatric medications are related to differences in estimated WBC proportions between SCZ cases and controls. DNA methylation data from whole blood was used to estimate proportions of six subtypes of WBCs in SCZ patients (n = 333) and healthy controls (n = 396). We tested the association of case-control status with estimated cell-type proportions and the neutrophil-to-lymphocyte ratio (NLR) in 4 models: with/without adjusting for time of blood draw, and then compared results from blood samples drawn during a 12-h (07:00–19:00) or 7-h (07:00-14:00) period. We also investigated WBC proportions in a subgroup of medication-free patients (n = 51). Neutrophil proportions were significantly higher in SCZ cases (mean=54.1%) vs. controls (mean=51.1%; p = <0.001), and CD8+T lymphocyte proportions were lower in SCZ cases (mean=12.1%) vs. controls (mean=13.2%; p = 0.001). The effect sizes in the 12-h sample (07:00–19:00) showed a significant difference between SCZ vs. controls for neutrophils, CD4+T, CD8+T, and B-cells, which remained significant after adjusting for time of blood draw. In the samples matched for time of blood draw during 07.00–14.00, we also observed an association with neutrophils, CD4+T, CD8+T, and B-cells that was unaffected by further adjustment for time of blood draw. In the medication-free patients, we observed differences that remained significant in neutrophils (p = 0.01) and CD4+T (p = 0.01) after adjusting for time of day. The association of SCZ with NLR was significant in all models (range: p < 0.001 to p = 0.03) in both medicated and unmedicated patients. In conclusion, controlling for pharmacological treatment and circadian cycling of WBC is necessary for unbiased estimates in case-control studies. Nevertheless, the association of WBC with SCZ remains, even after adjusting for the time of day.

• Haatveit, Beathe; Westlye, Lars Tjelta; Vaskinn, Anja; Flaaten, Camilla Bärthel; Mohn, Hanne Christine & Bjella, Thomas [Show all 12 contributors for this article] (2023). Intra- and inter-individual cognitive variability in schizophrenia and bipolar spectrum disorder: an investigation across multiple cognitive domains. Schizophrenia. 9(1). doi: 10.1038/s41537-023-00414-4. Full text in Research Archive Show summary

  There is substantial cognitive heterogeneity among patients with schizophrenia (SZ) and bipolar disorders (BD). More knowledge about the magnitude and clinical correlates of performance variability could improve our understanding of cognitive impairments. Using double generalized linear models (DGLMs) we investigated cognitive mean and variability differences between patients with SZ (n = 905) and BD spectrum disorders (n = 522), and healthy controls (HC, n = 1170) on twenty-two variables. The analysis revealed significant case-control differences on 90% of the variables. Compared to HC, patients showed larger intra-individual (within subject) variability across tests and larger inter-individual (between subject) variability in measures of fine-motor speed, mental processing speed, and inhibitory control (SZ and BD), and in verbal learning and memory and intellectual functioning (SZ). In SZ, we found that lager intra -and inter (on inhibitory control and speed functions) individual variability, was associated with lower functioning and more negative symptoms. Inter-individual variability on single measures of memory and intellectual function was additionally associated with disorganized and positive symptoms, and use of antidepressants. In BD, there were no within-subject associations with symptom severity. However, greater inter-individual variability (primarily on inhibitory control and speeded functions) was associated with lower functioning, more negative -and disorganized symptoms, earlier age at onset, longer duration of illness, and increased medication use. These results highlight larger individual differences in patients compared to controls on various cognitive domains. Further investigations of the causes and correlates of individual differences in cognitive function are warranted.

• Flaaten, Camilla Bärthel; Melle, Ingrid; Bjella, Thomas; Engen, Magnus Johan; Åsbø, Gina & Wold, Kristin Fjelnseth [Show all 13 contributors for this article] (2023). Long-term course of cognitive functioning in bipolar disorder: A ten-year follow-up study. Bipolar Disorders. ISSN 1398-5647. doi: 10.1111/bdi.13364. Full text in Research Archive Show summary

  Abstract Introduction Cognitive impairments are common in bipolar disorder (BD), but the long‐term course remains understudied. Longitudinal data on cognitive functioning from the start of the first treatment could help clarify pathophysiological processes that shape the illness outcome. We here aim to investigate the 10‐year cognitive course in BD compared to healthy controls (HC) and the effects of clinical symptoms on cognitive trajectories. Methods Fifty‐six BD participants recruited within their first year of treatment and 108 HC completed clinical and cognitive assessments at baseline and 10‐year follow‐up. We derived eight cognitive domain scores and a cognitive composite score, which were further investigated using linear mixed model analyses. Correlation analyses were used to assess associations between the composite score and depressive, manic and psychotic symptoms. Results BD participants performed poorer than HCs in all domains except mental speed and verbal fluency. Verbal learning and memory, verbal fluency and the composite score improved over time in both BD participants and HC, while short‐term memory, mental speed, psychomotor speed and working memory were stable. We found no significant correlations between cognition and symptom level at either time point in BD participants. Conclusions We found evidence of long‐term cognitive stability or improvement in BD participants from first treatment to 10‐year follow‐up. Though the BD group was impaired in all domains except mental speed and verbal fluency, the change in cognitive functioning was parallel to that of HCs. These findings are not consistent with the notion of neuroprogression in BD.

• Cheng, Weiqiu; Parker, Nadine; Karadag, Naz; Koch, Elise; Hindley, Guy Frederick Lanyon & Icick, Romain [Show all 22 contributors for this article] (2023). The relationship between cannabis use, schizophrenia, and bipolar disorder: a genetically informed study. The Lancet Psychiatry. ISSN 2215-0374. 10(6), p. 441–451. doi: 10.1016/S2215-0366(23)00143-8. Full text in Research Archive Show summary

  Background The relationship between psychotic disorders and cannabis use is heavily debated. Shared underlying genetic risk is one potential explanation. We investigated the genetic association between psychotic disorders (schizophrenia and bipolar disorder) and cannabis phenotypes (lifetime cannabis use and cannabis use disorder). Methods We used genome-wide association summary statistics from individuals with European ancestry from the Psychiatric Genomics Consortium, UK Biobank, and International Cannabis Consortium. We estimated heritability, polygenicity, and discoverability of each phenotype. We performed genome-wide and local genetic correlations. Shared loci were identified and mapped to genes, which were tested for functional enrichment. Shared genetic liabilities to psychotic disorders and cannabis phenotypes were explored using causal analyses and polygenic scores, using the Norwegian Thematically Organized Psychosis cohort. Findings Psychotic disorders were more heritable than cannabis phenotypes and more polygenic than cannabis use disorder. We observed positive genome-wide genetic correlations between psychotic disorders and cannabis phenotypes (range 0·22–0·35) with a mixture of positive and negative local genetic correlations. Three to 27 shared loci were identified for the psychotic disorder and cannabis phenotype pairs. Enrichment of mapped genes implicated neuronal and olfactory cells as well as drug–gene targets for nicotine, alcohol, and duloxetine. Psychotic disorders showed a causal effect on cannabis phenotypes, and lifetime cannabis use had a causal effect on bipolar disorder. Of 2181 European participants from the Norwegian Thematically Organized Psychosis cohort applied in polygenic risk score analyses, 1060 (48·6%) were females and 1121 (51·4%) were males (mean age 33·1 years [SD 11·8]). 400 participants had bipolar disorder, 697 had schizophrenia, and 1044 were healthy controls. Within this sample, polygenic scores for cannabis phenotypes predicted psychotic disorders independently and improved prediction beyond the polygenic score for the psychotic disorders. Interpretation A subgroup of individuals might have a high genetic risk of developing a psychotic disorder and using cannabis. This finding supports public health efforts to reduce cannabis use, particularly in individuals at high risk or patients with psychotic disorders. Identified shared loci and their functional implications could facilitate development of novel treatments.

• Bauer, Michael; Glenn, Tasha; Achtyes, Eric D.; Alda, Martin; Agaoglu, Esen & Altınbaş, Kürşat [Show all 159 contributors for this article] (2022). Association between polarity of first episode and solar insolation in bipolar I disorder. Journal of Psychosomatic Research. ISSN 0022-3999. 160. doi: 10.1016/j.jpsychores.2022.110982. Full text in Research Archive Show summary

  Objective Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth. Methods Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer. Results The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001). Conclusion Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.

• Icick, Romain; Melle, Ingrid; Etain, Bruno; Høegh, Margrethe Collier; Gard, Sébastien & Aminoff, Sofie Ragnhild [Show all 15 contributors for this article] (2022). Preventive Medication Patterns in Bipolar Disorder and Their Relationship With Comorbid Substance Use Disorders in a Cross-National Observational Study. Frontiers in Psychiatry. 13. doi: 10.3389/fpsyt.2022.813256. Full text in Research Archive Show summary

  Objective The potential role of sub-optimal pharmacological treatment in the poorer outcomes observed in bipolar disorder (BD) with vs. without comorbid substance use disorders (SUDs) is not known. Thus, we investigated whether patients with BD and comorbid SUD had different medication regimens than those with BD alone, in samples from France and Norway, focusing on compliance to international guidelines. Methods Seven hundred and seventy patients from France and Norway with reliably ascertained BD I or II (68% BD-I) were included. Medication information was obtained from patients and hospital records, and preventive treatment was categorized according to compliance to guidelines. We used Bayesian and regression analyses to investigate associations between SUD comorbidity and medication. In the Norwegian subsample, we also investigated association with lack of medication. Results Comorbid SUDs were as follows: current tobacco smoking, 26%, alcohol use disorder (AUD), 16%; cannabis use disorder (CUD), 10%; other SUDs, 5%. Compliance to guidelines for preventive medication was lacking in 8%, partial in 44%, and complete in 48% of the sample. Compliance to guidelines was not different in BD with and without SUD comorbidity, as was supported by Bayesian analyses (highest Bayes Factor = 0.16). Cross national differences in treatment regimens led us to conduct country-specific adjusted regression analyses, showing that (1) CUD was associated with increased antipsychotics use in France (OR = 2.4, 95% CI = 1.4–3.9, p = 0.001), (2) current tobacco smoking was associated with increased anti-epileptics use in Norway (OR = 4.4, 95% CI = 1.9–11, p &amp;lt; 0.001), and (3) AUD was associated with decreased likelihood of being medicated in Norway (OR = 1.2, 95% CI = 1.04–1.3, p = 0.038). Conclusion SUD comorbidity in BD was overall not associated with different pharmacological treatment in our sample, and not related to the level of compliance to guidelines. We found country-specific associations between comorbid SUDs and specific medications that warrant further studies.

• Flaaten, Camilla Bärthel; Melle, Ingrid; Gardsjord, Erlend Strand; Bjella, Thomas; Engen, Magnus Johan & Vaskinn, Anja [Show all 13 contributors for this article] (2022). Course of intellectual functioning in schizophrenia and bipolar disorder: A 10-year follow-up study. Psychological Medicine. ISSN 0033-2917. p. 1–9. doi: 10.1017/S0033291721004645. Full text in Research Archive Show summary

  Background Intellectual functioning (IQ) is lower in schizophrenia patients compared to healthy controls, with bipolar patients intermediate between the two. Declines in IQ mark the onset of schizophrenia, while stability is generally found post-onset. There are to date few studies on long-term IQ development in bipolar disorder. This study presents 10-year follow-up data on IQ, including premorbid IQ estimates, to track the developmental course from pre-onset levels to long-term outcomes in both patient groups compared to healthy controls. Methods We included 139 participants with schizophrenia, 76 with bipolar disorder and 125 healthy controls. Mixed model analyses were used to estimate developmental slopes for IQ scores from estimated premorbid level (NART IQ) through baseline (WASI IQ) measured within 12 months post-onset, to 10-year follow-up (WASI IQ), with pairwise group comparisons. The best fit was found using a model with a breakpoint at baseline assessment. Results Only the schizophrenia group had significant declines from estimated premorbid to baseline IQ levels compared to controls. When comparing patient groups, schizophrenia patients had steeper declines than the bipolar group. Increases in IQ were found in all groups over the follow-up period. Conclusions Trajectories of IQ from premorbid level to 10-year follow-up indicated declines from estimated premorbid level to illness onset in both patient groups, followed by increases during the follow-up period. Schizophrenia patients had a steeper decline than bipolar patients. During follow-up, increases indicate developmental improvement for both patient groups, but with a maintained lag compared to healthy controls due to lower premorbid levels.

• Flaaten, Camilla Bärthel; Melle, Ingrid; Bjella, Thomas; Engen, Magnus Johan; Åsbø, Gina & Wold, Kristin Fjelnseth [Show all 14 contributors for this article] (2022). Domain-specific cognitive course in schizophrenia: Group- and individual-level changes over 10 years. Schizophrenia Research: Cognition. 30, p. 1–8. doi: 10.1016/j.scog.2022.100263. Full text in Research Archive Show summary

  Cognitive impairments in schizophrenia are well-documented, present across several cognitive domains and found to be relatively stable over time. However, there is a high degree of heterogeneity and indications of domain-specific developmental courses. The present study investigated the 10-year cognitive course in participants with first-episode schizophrenia (FES) and healthy controls on eight cognitive domains and a composite score, looking at group- and individual-level changes. A total of 75 FES participants and 91 healthy controls underwent cognitive assessment at baseline and follow-up. Linear mixed models were used for group-level analyses and reliable change index (RCI) analyses were used to investigate individual change. The prevalence of clinically significant impairment was explored at both time points, using a cut-off of < −1.5 SD, with significant cognitive impairment defined as impairment on ≥2 domains. Group-level analyses found main effects of group and time, and time by group interactions. Memory, psychomotor processing speed and verbal fluency improved, while learning, mental processing speed and working memory were stable in both groups. FES participants showed deteriorations in attention and cognitive control. Individual-level analyses mainly indicated stability in both FES and controls, except for a higher prevalence of decline in cognitive control in FES. At baseline, 68.8 % of FES participants had clinically significant impairment, compared to 62.3 % at follow-up. We mainly found long-term stability and modest increases in cognition over time in FES, as well as a high degree of within-group heterogeneity. We also found indications of deterioration in participants with worse cognitive performance at baseline.

• Bjella, Thomas; Høegh, Margrethe Collier; Olsen, Stine Holmstul; Aminoff, Sofie Ragnhild; Barrett, Elizabeth Ann & Ueland, Torill [Show all 14 contributors for this article] (2022). Developing "MinDag" - an app to capture symptom variation and illness mechanisms in bipolar disorder. Frontiers in Medical Technology. 4. doi: 10.3389/fmedt.2022.910533. Full text in Research Archive Show summary

  Introduction: The illness course of bipolar disorder (BD) is highly heterogeneous with substantial variation between individuals with the same BD subtype and within individuals over time. This heterogeneity is not well-delineated and hampers the development of more targeted treatment. Furthermore, although lifestyle-related behaviors are believed to play a role in the illness course, such mechanisms are poorly understood. To address some of these knowledge gaps, we aimed to develop an app for collection of multi-dimensional longitudinal data on BD-relevant symptoms and lifestyle-related behaviors. Methods: An app named MinDag was developed at the Norwegian Center for Mental Disorders Research in Oslo, Norway. The app was designed to tap into selected areas: mood, sleep, functioning/activities (social, occupational, physical exercise, leisure), substance use, emotional reactivity, and psychotic experiences. Ethical, security and usability issues were highly prioritized throughout the development and for the final app solution. We conducted beta- and pilot testing to eliminate technical problems and enhance usability and acceptability. Results: The final version of MinDag comprises six modules; three which are presented for the user once daily (the Sleep module in the morning and the Mood and Functoning/Activities modules in the evening) and three which are presented once weekly (Substance Use, Emotional Reactivity, and Psychotic Experiences modules). In general, MinDag was well received in both in the beta-testing and the pilot study, and the participants provided valuable feedback that was taken into account in the final development. MinDag is now in use as part of the research protocol at the NORMENT center and in a specialized treatment unit for BD at Oslo University Hospital in Norway. Discussion: We believe that MinDag will generate unique longitudinal data well suited for capturing the heterogeneity of BD and clarifying important unresolved issues such as how life-style related behavior may influence BD symptoms. Also, the experiences and knowledge derived from the development of MinDag may contribute to improving the security, acceptability, and benefit of digital tools in mental health.

• Åsbø, Gina; Ueland, Torill; Haatveit, Beathe; Bjella, Thomas; Flaaten, Camilla Bärthel & Wold, Kristin Fjelnseth [Show all 13 contributors for this article] (2022). The Time is Ripe for a Consensus Definition of Clinical Recovery in First-episode Psychosis: Suggestions Based on a 10-Year Follow-up Study. Schizophrenia Bulletin. ISSN 0586-7614. 48(4), p. 839–849. doi: 10.1093/schbul/sbac035. Full text in Research Archive Show summary

  Abstract Objectives A consensus definition of clinical recovery in first-episode psychosis (FEP) is required to improve knowledge about recovery rates in this population. To propose criteria for a future consensus definition, this study aims to investigate rates of clinical recovery when using a standard definition (full psychotic symptom remission and adequate functioning for minimum one year) across both affective and nonaffective FEP groups (bipolar spectrum and schizophrenia spectrum disorders). Second, we aim to explore changes in rates when altering the standard definition criteria. Third, to examine the extent to which healthy controls meet the functioning criteria. Study design In total, 142 FEP participants and 117 healthy controls preselected with strict criteria, were re-assessed with structured clinical interviews at 10-year follow-up. Study results A total of 31.7% were in clinical recovery according to the standard definition, with significantly higher recovery rates in bipolar (50.0%) than in schizophrenia spectrum disorders (22.9%). Both groups’ recovery rates decreased equally when extending duration and adding affective symptom remission criteria and increased with looser functioning criteria. In healthy controls, 18.8% did not meet the standard criteria for adequate functioning, decreasing to 4.3% with looser criteria. Conclusions Findings suggest that clinical recovery is common in FEP, although more in bipolar than in schizophrenia spectrum disorders, also when altering the recovery criteria. We call for a future consensus definition of clinical recovery for FEP, and suggest it should include affective symptom remission and more reasonable criteria for functioning that are more in line with the general population.

• Bauer, Michael; Glenn, Tasha; Achtyes, Eric D.; Alda, Martin; Agaoglu, Esen & Altınbaş, Kürşat [Show all 50 contributors for this article] (2021). Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder. International journal of bipolar disorders. 9. doi: 10.1186/s40345-021-00231-7. Full text in Research Archive Show summary

  Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.

• Lagerberg, Trine Vik; Icick, Romain; Aminoff, Sofie Ragnhild; Nerhus, Mari; Barrett, Elizabeth Ann & Bjella, Thomas [Show all 9 contributors for this article] (2021). Substance Misuse Trajectories and Risk of Relapse in the Early Course of Bipolar Disorder. Frontiers in Psychiatry. 12, p. 1–9. doi: 10.3389/fpsyt.2021.656912. Full text in Research Archive Show summary

  Substance misuse is highly prevalent in bipolar disorder even in the early illness phases. However, the trajectories of misuse of different substances after treatment initiation is not well-studied. Also, knowledge on how substance misuse trajectories influence the early course of bipolar disorder is limited. We recruited 220 individuals in first treatment of bipolar disorder of which 112 participated in a 1-year follow-up study at the NORMENT center in Oslo, Norway. Misuse was defined as having scores above cut-off for harmful use on the Alcohol or Drug Use Disorders Identification Tests (AUDIT or DUDIT). We investigated rates of stopping and continuing misuse of alcohol, cannabis and other illicit substances and daily nicotine use over the follow-up period, and whether such misuse trajectories predicted the risk for affective relapse. The prevalence of cannabis misuse was reduced from 29 to 15% and alcohol misuse was reduced from 39 to 21% during follow-up. Continuing alcohol misuse significantly and independently predicted affective relapse, whereas there was no difference in relapse risk between individuals stopping alcohol misuse and never misusing alcohol. Cannabis misuse trajectories did not significantly predict relapse risk although we cannot exclude interactions with alcohol misuse. In conclusion, substance misuse decreased in the early phase of bipolar disorder treatment but should be further reduced with interventions specifically addressing substance misuse. Stopping alcohol misuse is likely to yield substantial benefit on the clinical course of bipolar disorder.

• Szabo, Attila; Akkouh, Ibrahim; Ueland, Thor; Lagerberg, Trine Vik; Dieset, Ingrid & Bjella, Thomas [Show all 12 contributors for this article] (2020). Cannabis Use Is Associated With Increased Levels of Soluble gp130 in Schizophrenia but Not in Bipolar Disorder. Frontiers in Psychiatry. 11, p. 1–10. doi: 10.3389/fpsyt.2020.00642. Full text in Research Archive Show summary

  The complex effects of plant cannabinoids on human physiology is not yet fully understood, but include a wide spectrum of effects on immune modulation. The immune system and its inflammatory effector pathways are recently emerging as possible causative factors in psychotic disorders. The present study aimed to investigate whether self-administered Cannabis use was associated with changes in circulating immune and neuroendocrine markers in schizophrenia (SCZ) and bipolar disorder (BD) patients. A screening of 13 plasma markers reflecting different inflammatory pathways was performed in SCZ (n = 401) and BD patients (n = 242) after subdividing each group into Cannabis user and non-user subgroups. We found that i) soluble gp130 (sgp130) concentrations were significantly elevated among Cannabis users in the SCZ group (p = 0.002) after multiple testing correction, but not in BD. ii) Nominally significant differences were observed in the levels of IL-1RA (p = 0.0059), YKL40 (p = 0.0069), CatS (p = 0.013), sTNFR1 (p = 0.031), and BDNF (p = 0.020), where these factors exhibited higher plasma levels in Cannabis user SCZ patients than in non-users. iii) These differences in systemic levels were not reflected by altered mRNA expression of genes encoding sgp130, IL-1RA, YKL40, CatS, sTNFR1, and BDNF in whole blood. Our results show that Cannabis self-administration is associated with markedly higher sgp130 levels in SCZ, but not in BD, and that this phenomenon is independent of the modulation of peripheral immune cells. These findings warrant further investigation into the potential IL-6 trans-signaling modulatory, anti-inflammatory, neuroimmune, and biobehavioral-cognitive effects of Cannabis use in SCZ.

• Anderssen, Jannicke Fjæra; Simonsen, Carmen Elisabeth; Büchmann, Camilla Bakkalia; Barrett, Elizabeth Ann; Bjella, Thomas & Lagerberg, Trine Vik [Show all 10 contributors for this article] (2019). Sleep disturbances in schizophrenia spectrum and bipolar disorders ? a transdiagnostic perspective. Comprehensive Psychiatry. ISSN 0010-440X. 91, p. 6–12. doi: 10.1016/j.comppsych.2019.02.006. Full text in Research Archive Show summary

  Background Sleep disturbances are prevalent in severe mental disorders but their type and frequency across diagnostic categories has not been investigated in large scale studies. Methods Participants with Schizophrenia spectrum disorders (SCZ, (N = 617)), Bipolar disorders (BD, (N = 440)), and Healthy Controls (HC, (N = 173)) were included in the study. Sleep disturbances (insomnia, hypersomnia and delayed sleep phase) were identified based on items from the Inventory of Depressive Symptoms – Clinician rated scale. Clinical symptoms were assessed with the Positive and Negative Syndrome scale and level of functioning with the Global assessment of Functioning scale. Results The rate of any sleep disturbance was 78% in SZ, 69% in BD and 39% in HC. Insomnia was the most frequently reported sleep disturbance across all groups. Both diagnostic groups reported significantly more of any sleep disturbances than HC (P < 0.001). Having a sleep disturbance was associated with more severe negative and depressive symptoms and with lower functioning across diagnostic groups (P < 0.001, η2 = 0.0071). Hypersomnia was the only sleep disturbance associated with previous treatment history. Conclusion Sleep disturbances, including insomnia, hypersomnia and delayed sleep phase, are frequent in SCZ and BD, and associated with more severe clinical symptomatology across diagnostic groups. This suggests that sleep disturbance is a clinically relevant transdiagnostic phenomenon.

• Bauer, Michael; Glenn, Tasha; Alda, Martin; Andreassen, Ole Andreas; Angelopoulos, Elias & Ardau, Raffaella [Show all 105 contributors for this article] (2019). Association between solar insolation and a history of suicide attempts in bipolar I disorder. Journal of Psychiatric Research. ISSN 0022-3956. 113, p. 1–9. doi: 10.1016/j.jpsychires.2019.03.001. Full text in Research Archive
• Torske, Tonje; Nærland, Terje; Bettella, Francesco; Bjella, Thomas; Malt, Eva Albertsen & Høyland, Anne Lise [Show all 9 contributors for this article] (2019). Autism spectrum disorder polygenic scores are associated with every day executive function in children admitted for clinical assessment. Autism Research. ISSN 1939-3792. 13(2). doi: 10.1002/aur.2207. Full text in Research Archive Show summary

  Autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDs) are behaviorally defined disorders with overlapping clinical features that are often associated with higher-order cognitive dysfunction, particularly executive dysfunction. Our aim was to determine if the polygenic score (PGS) for ASD is associated with parent-reported executive dysfunction in everyday life using the Behavior Rating Inventory of Executive Function (BRIEF). Furthermore, we investigated if PGS for general intelligence (INT) and attention deficit/hyperactivity disorder (ADHD) also correlate with BRIEF. We included 176 children, adolescents and young adults aged 5–22 years with full-scale intelligence quotient (IQ) above 70. All were admitted for clinical assessment of ASD symptoms and 68% obtained an ASD diagnosis. We found a significant difference between low and high ASD PGS groups in the BRIEF behavior regulation index (BRI) (P = 0.015, Cohen’s d = 0.69). A linear regression model accounting for age, sex, full-scale IQ, Social Responsiveness Scale (SRS) total score, ASD, ADHD and INT PGS groups as well as genetic principal components, significantly predicted the BRI score; F(11,130) = 8.142, P < 0.001, R2 = 0.41 (unadjusted). Only SRS total (P < 0.001), ASD PGS 0.1 group (P = 0.018), and sex (P = 0.022) made a significant contribution to the model. This suggests that the common ASD risk gene variants have a stronger association to behavioral regulation aspects of executive dysfunction than ADHD risk or INT variants in a clinical sample with ASD symptoms. Autism Res 2019, 00: 1–14. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay Summary: People with autism spectrum disorder (ASD) often have difficulties with higher-order cognitive processes that regulate thoughts and actions during goal-directed behavior, also known as executive function (EF). We studied the association between genetics related to ASD and EF and found a relation between high polygenic score (PGS) for ASD and difficulties with behavior regulation aspects of EF in children and adolescents under assessment for ASD. Furthermore, high PGS for general intelligence was related to social problems. Keywords: autism spectrum disorder; polygenic score; executive function; attention deficit/hyperactivity disorder; behavior rating inventory of executive function

• Icick, Romain; Melle, Ingrid; Étain, Bruno; Ringen, Petter Andreas; Aminoff, Sofie Ragnhild & Leboyer, Marion. [Show all 12 contributors for this article] (2019). Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder. Journal of Affective Disorders. ISSN 0165-0327. 256, p. 348–357. doi: 10.1016/j.jad.2019.05.075. Full text in Research Archive
• Simonsen, Carmen Elisabeth; Færden, Ann; Ueland, Torill; Vaskinn, Anja; Bjella, Thomas & Andreassen, Ole Andreas [Show all 8 contributors for this article] (2018). Self-rated disability in first treated episode of psychosis: A 1-year follow-up study. Comprehensive Psychiatry. ISSN 0010-440X. 85, p. 48–54. doi: 10.1016/j.comppsych.2018.06.004. Full text in Research Archive Show summary

  Objectives: Knowledge about self-rated disability over time in psychotic disorders is limited. How self-rateddisability relates to clinician-rated global functioning, self-rated life satisfaction and symptomatology wasinvestigated across thefirst year of treatment in early psychosis. Methods: Participants withfirst treated episode of psychosis (n= 115) were investigated at baseline and 1-yearfollow-up. Self-rated Disability was measured with World Health Organization- Disability Assessment Schedule2.0. Clinician-rated global functioning, self-rated life satisfaction, and symptomatology were measured withappropriate scales. Results: Average self-rated disability infirst-treated episode of psychosis was high, corresponding with the 10%highest in a general population sample. However, 37% werenotdisabled at a clinically significant level afterone year. Self-rated disability was highest in the two social domains (Getting along with people and Participationin society), but improved significantly from baseline to 1-year. At 1-year follow-up self-rated disability hadsignificant weak to medium correlations with clinician-rated global functioning and positive symptoms,and mainly medium to strong correlations with life satisfaction and depressive symptoms. Yet only baselinedepression significantly predicted disability after one year. Conclusion: Self-rated disability infirst treated episode of psychosis is high, but improves across thefirst year,indicating signs of early recovery. Moreover,self-rateddisability isrelated, but distinct fromclinician-ratedglobalfunctioning and self-rated life satisfaction, suggesting that self-rated disability should also be assessed in order tomore fully describe outcomes infirst episode psychosis. Thefindings highlight the need for specialised treatmentof depression and social disability in early psychosis.

• Bauer, Michael; Glenn, T; Alda, M; Aleksandrovich, MA; Andreassen, Ole Andreas & Angelopoulos, E [Show all 104 contributors for this article] (2017). Solar insolation in springtime influences age of onset of bipolar I disorder. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 136(6), p. 571–582. doi: 10.1111/acps.12772. Full text in Research Archive
• Nerhus, Mari; Berg, Akiah Ottesen; Simonsen, Carmen Elisabeth; Haram, Marit; Haatveit, Beathe Christin & Dahl, Sandra Rinne [Show all 11 contributors for this article] (2017). Vitamin D deficiency associated with cognitive functioning in psychotic disorders. Journal of Clinical Psychiatry. ISSN 0160-6689. 78(7), p. e750–e757. doi: 10.4088/JCP.16m10880. Full text in Research Archive
• Vaskinn, Anja; Lagerberg, Trine Vik; Bjella, Thomas; Simonsen, Carmen Elisabeth; Andreassen, Ole Andreas & Ueland, Torill [Show all 7 contributors for this article] (2017). Impairment in emotion perception from body movements in individuals with bipolar I and bipolar II disorder is associated with functional capacity. International journal of bipolar disorders. 5(13), p. 1–9. doi: 10.1186/s40345-017-0083-7. Full text in Research Archive Show summary

  Background Individuals with bipolar disorder present with moderate impairments in social cognition during the euthymic state. The impairment extends to theory of mind and to the perception of emotion in faces and voices, but it is unclear if emotion perception from body movements is affected. The main aim of this study was to examine if participants with bipolar disorder perform worse than healthy control participants on a task using point-light displays of human full figures moving in a manner indicative of a basic emotion (angry, happy, sad, fearful, neutral/no emotion). A secondary research question was whether diagnostic subtypes (bipolar I, bipolar II) and history of psychosis impacted on this type of emotion perception. Finally, symptomatic, neurocognitive, and functional correlates of emotion perception from body movements were investigated. Methods Fifty-three individuals with bipolar I (n = 29) or bipolar II (n = 24) disorder, and 84 healthy control participants were assessed for emotion perception from body movements. The bipolar group also underwent clinical, cognitive, and functional assessment. Research questions were analyzed using analyses of variance and bivariate correlations. Results The bipolar disorder group differed significantly from healthy control participants for emotion perception from body movements (Cohen’s d = 0.40). Analyses of variance yielded no effects of sex, diagnostic subtype (bipolar I, bipolar II), or history of psychosis. There was an effect of emotion, indicating that some emotions are easier to recognize. The lack of a significant group × emotion interaction effect points, however, to this being so regardless of the presence of bipolar disorder. Performance was unrelated to manic and depressive symptom load but showed significant associations with neurocognition and functional capacity. Conclusions Individuals with bipolar disorder had a small but significant impairment in the ability to perceive emotions from body movement. The impairment was global, i.e., affecting all emotions and equally present for males and females. The impairment was associated with neurocognition and functional capacity, but not symptom load. Our findings identify pathopsychological factors underlying the functional impairment in bipolar disorder and suggest the consideration of social cognition training as part of the treatment for bipolar disorder.

• Simonsen, Carmen Elisabeth; Færden, Ann; Romm, Kristin Lie; Berg, Akiah Ottesen; Bjella, Thomas & Sundet, Kjetil Søren [Show all 9 contributors for this article] (2017). Early clinical recovery in first-episode psychosis: Symptomatic remission and its correlates at 1-year follow-up. Psychiatry Research. ISSN 0165-1781. 254, p. 118–125. doi: 10.1016/j.psychres.2017.04.050. Full text in Research Archive
• Nesvåg, Ragnar; Jönsson, Erik Gunnar; Bakken, Inger Johanne; Knudsen, Gun Peggy; Bjella, Thomas & Reichborn-Kjennerud, Ted [Show all 8 contributors for this article] (2017). The quality of severe mental disorder diagnoses in a national health registry as compared to research diagnoses based on structured interview. BMC Psychiatry. 17(1). doi: 10.1186/s12888-017-1256-8. Full text in Research Archive Show summary

  Background Utilization of diagnostic information from national patient registries rests on the quality of the registered diagnoses. We aimed to investigate the agreement and consistency of diagnoses of psychotic and bipolar disorders in the Norwegian Patient Registry (NPR) compared to structured interview-based diagnoses given as part of a clinical research project. Methods Diagnostic data from NPR were obtained for the period 01.01.2008–31.12.2013 for all patients who had been included in the Thematically Organized Psychosis (TOP) study between 18.10.2002 and 01.09.2014 with a Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnosis of schizophrenia (n = 537), delusional disorder (n = 48), schizoaffective disorder (n = 118) or bipolar disorder (n = 408). Diagnostic agreement between the primary DSM-IV diagnosis in TOP and the International Classification of Diseases, 10th revision (ICD-10) diagnoses in NPR was evaluated using Cohen’s unweighted nominal kappa (κ). Diagnostic consistency was calculated as the proportion of all registered severe mental disorder diagnoses in NPR that were equivalent to the primary diagnosis given in the TOP study. Results The proportion of patients registered with the equivalent ICD-10 diagnosis as the primary DSM-IV diagnosis given in TOP was 84.2% for the schizophrenia group, 68.8% for the delusional disorder group, 76.3% for the schizoaffective disorder group, and 78.4% for the bipolar disorder group. Diagnostic agreement was good for schizophrenia (κ = 0.74) and bipolar disorder (κ = 0.72), fair for schizoaffective disorder (κ = 0.63), and poor for delusional disorder (κ = 0.39). Among patients with DSM-IV schizophrenia, 4.7% were diagnosed with ICD-10 bipolar disorder, and among patients with DSM-IV bipolar disorder, 2.5% were diagnosed with ICD-10 schizophrenia. Diagnostic consistency was 84.9% for schizophrenia, 59.1% for delusional disorder, 65.9% for schizoaffective disorder, and 91.0% for bipolar disorder. Conclusions When compared to research-based diagnoses, clinical diagnoses of schizophrenia and bipolar disorder in the NPR are accurate and consistent, with minimal diagnostic overlap between the two disorders.

• Aas, Monica; Melle, Ingrid; Bettella, Francesco; Djurovic, Srdjan; Hellard, Stephanie Le & Bjella, Thomas [Show all 12 contributors for this article] (2017). Psychotic patients who used cannabis frequently before illness onset have higher genetic predisposition to schizophrenia than those who did not. Psychological Medicine. ISSN 0033-2917. 48(1), p. 43–49. doi: 10.1017/S0033291717001209. Full text in Research Archive Show summary

  Background Schizophrenia (SZ) and bipolar disorder (BD) are heritable, polygenic disorders with shared clinical and genetic components, suggesting a psychosis continuum. Cannabis use is a well-documented environmental risk factor in psychotic disorders. In the current study, we investigated the relationship between SZ genetic load and cannabis use before illness onset in SZ and BD spectrums. Since frequent early cannabis use (age <18 years) is believed to increase the risk of developing psychosis more than later use, follow-up analyses were conducted comparing early use to later use and no use. Methods We assigned a SZ-polygenic risk score (PGRS) to each individual in our independent sample (N = 381 SZ spectrum cases, 220 BD spectrum cases and 415 healthy controls), calculated from the results of the Psychiatric Genomics Consortium (PGC) SZ case–control study (N = 81 535). SZ-PGRS in patients who used cannabis weekly to daily in the period before first illness episode was compared with that of those who never or infrequently used cannabis. Results Patients with weekly to daily cannabis use before illness onset had the highest SZ-PGRS (p = 0.02, Cohen's d = 0.33). The largest difference was found between patients with daily or weekly cannabis use before illness onset <18 years of age and patients with no or infrequent use of cannabis (p = 0.003, Cohen's d = 0.42). Conclusions Our study supports an association between high SZ-PGRS and frequent cannabis use before illness onset in psychosis continuum disorders.

• Lagerberg, Trine Vik; Aminoff, Sofie Ragnhild; Aas, Monica; Bjella, Thomas; Henry, Chantal & Leboyer, Marion [Show all 12 contributors for this article] (2017). Alcohol use disorders are Associated With increased effective lability in bipolar disorder. Journal of Affective Disorders. ISSN 0165-0327. 208, p. 316–324. doi: 10.1016/j.jad.2016.09.062. Full text in Research Archive
• Aas, Monica; Henry, C.; Bellivier, F; Lajnef, M; Gard, S & Kahn, J-P [Show all 13 contributors for this article] (2017). Affective lability mediates the association between childhood trauma and suicide attempts, mixed episodes and co-morbid anxiety disorders in bipolar disorders. Psychological Medicine. ISSN 0033-2917. 47(5), p. 902–912. doi: 10.1017/S0033291716003081. Full text in Research Archive
• Lagerberg, Trine Vik; Icick, R.; Andreassen, Ole Andreas; Ringen, Petter Andreas; Etain, B & Aas, Monica [Show all 10 contributors for this article] (2016). Cannabis use disorder is associated with greater illness severity in tobacco smoking patients with bipolar disorder. Journal of Affective Disorders. ISSN 0165-0327. 190, p. 286–293. doi: 10.1016/j.jad.2015.10.023. Full text in Research Archive
• Haram, Marit; Bettella, Francesco; Brandt, Christine Lycke; Quintana, Daniel; Nerhus, Mari & Bjella, Thomas [Show all 11 contributors for this article] (2016). Contribution of oxytocin receptor polymorphisms to amygdala activation in schizophrenia spectrum disorders. BJPsych Open. 2(6), p. 353–358. doi: 10.1192/bjpo.bp.116.003376. Full text in Research Archive Show summary

  Background Oxytocin has been proposed to mediate amygdala dysfunction associated with altered emotion processing in schizophrenia, but the contribution of oxytocin pathway genes is yet to be investigated. Aims To identify potential different contributions of three oxytocin receptor polymorphisms (rs53576, rs237902 and rs2254298) between patients with schizophrenia spectrum disorders (SCZ), affective spectrum disorders (AD) and healthy controls (HC). Method In a total of 346 participants (104 with SCZ, 100 with AD, and 142 HC) underwent genotyping and functional magnetic resonance imaging (fMRI) during an emotional faces matching paradigm. Genetic association analyses were performed to test the possible effects on task-induced BOLD amygdala response to fearful/angry faces. Results In participants with SCZ, the rs237902 G allele was associated with low amygdala activation (left hemisphere: b=−4.99, Bonferroni corrected P=0.04) and interaction analyses showed that this association was disorder specific (left hemisphere: Bonferroni corrected P=0.003; right hemisphere: Bonferroni corrected P=0.03). There were no associations between oxytocin polymorphisms and amygdala activation in the total sample, among AD patients or HC. Conclusions Rs237902 was associated with amygdala activation in response to fearful/angry faces only in patients with SCZ. Our findings indicate that the endogenous oxytocin system could serve as a contributing factor in biological underpinnings of emotion processing and that this contribution is disorder specific.

• Bauer, Michael; Glenn, T; Alda, M; Andreassen, Ole Andreas; Angelopoulos, E & Ardau, R [Show all 72 contributors for this article] (2015). Influence of birth cohort on age of onset cluster analysis in bipolar I disorder. European psychiatry. ISSN 0924-9338. 30(1), p. 99–105. doi: 10.1016/j.eurpsy.2014.10.005. Full text in Research Archive
• Bauer, Michael; Glenn, Tasha; Alda, Martin; Andreassen, Ole Andreas; Angelopoulos, Elias & Ardau, Raffaella [Show all 74 contributors for this article] (2015). Influence of light exposure during early life on the age of onset of bipolar disorder. Journal of Psychiatric Research. ISSN 0022-3956. 64, p. 1–8. doi: 10.1016/j.jpsychires.2015.03.013. Full text in Research Archive
• Nerhus, Mari; Berg, Akiah Ottesen; Dahl, Sandra Rinne; Holvik, Kristin; Gardsjord, Erlend Strand & Weibell, Melissa Anne E.a [Show all 9 contributors for this article] (2015). Vitamin D status in psychotic disorder patients and healthy controls - The influence of ethnic background. Psychiatry Research. ISSN 0165-1781. 230(2), p. 616–621. doi: 10.1016/j.psychres.2015.10.015. Full text in Research Archive Show summary

  Vitamin D deficiency is common among patients with psychotic disorders and could be due to unknown disease mechanisms or contingent factors. However most studies are performed in chronic patients and have often failed to address the influence of ethnicity on vitamin D levels in clinical samples. We investigated serum concentrations of 25-hydroxy vitamin D (S-25 OH D) in first episode patients compared to patients with multi episodes and healthy controls; with a specific focus on differences between visible ethnic minorities and participants from the majority population. A total of 284 participants were included in this cross-sectional study. First episode patients with a DSM-IV psychotic disorder were matched on age, gender and ethnicity to participants from a multi episode patient sample (1:1) and healthy controls (1:2). We did not find any differences between either patient groups or the healthy controls, but participants from visible ethnic minorities had significantly lower S-25 OH D than participants from the majority population. This implies that S-25 OH D should be routinely measured in persons from visible ethnic minorities since low levels are associated with higher levels of depressive symptoms

• Aas, Monica; Haukvik, Unn Kristin H.; Djurovic, Srdjan; Tesli, Martin Steen; Athanasiu, Lavinia & Bjella, Thomas [Show all 11 contributors for this article] (2014). Interplay between childhood trauma and BDNF val66met variants on blood BDNF mRNA levels and on hippocampus subfields volumes in schizophrenia spectrum and bipolar disorders. Journal of Psychiatric Research. ISSN 0022-3956. 59, p. 14–21. doi: 10.1016/j.jpsychires.2014.08.011. Full text in Research Archive
• Aas, Monica; Pedersen, Geir Feigum; Henry, Chantal; Bjella, Thomas; Bellivier, Frank & Leboyer, Marion [Show all 14 contributors for this article] (2014). Psychometric properties of the Affective Lability Scale (54 and 18-item version) in patients with bipolar disorder, first-degree relatives, and healthy controls. Journal of Affective Disorders. ISSN 0165-0327. 172, p. 375–380. doi: 10.1016/j.jad.2014.10.028. Full text in Research Archive
• Bauer, Michael; Glenn, T; Alda, Martin; Andreassen, Ole Andreas; Angelopoulos, Elias & Ardau, R [Show all 72 contributors for this article] (2014). Relationship between sunlight and the age of onset of bipolar disorder: An international multisite study. Journal of Affective Disorders. ISSN 0165-0327. 167, p. 104–111. doi: 10.1016/j.jad.2014.05.032. Full text in Research Archive
• Bauer, Michael; Glenn, T; Alda, M; Andreassen, Ole Andreas; Ardau, R & Bellivier, F [Show all 40 contributors for this article] (2012). Impact of sunlight on the age of onset of bipolar disorder. Bipolar Disorders. ISSN 1398-5647. 14(6), p. 654–663. doi: 10.1111/j.1399-5618.2012.01025.x. Full text in Research Archive
• Dieset, Ingrid; Hope, Sigrun; Ueland, Thor; Bjella, Thomas; Agartz, Ingrid & Melle, Ingrid [Show all 9 contributors for this article] (2012). Cardiovascular risk factors during second generation antipsychotic treatment are associated with increased C-reactive protein. Schizophrenia Research. ISSN 0920-9964. 140(1-3), p. 169–174. doi: 10.1016/j.schres.2012.06.040. Full text in Research Archive
• Djurovic, Srdjan; Gustafsson, Omar; Mattingsdal, Morten; Athanasiu, Lavinia; Bjella, Thomas & Tesli, Martin Steen [Show all 11 contributors for this article] (2010). A genome-wide association study of bipolar disorder in Norwegian individuals, followed by replication in Icelandic sample. Journal of Affective Disorders. ISSN 0165-0327. 126(1-2), p. 312–316. doi: 10.1016/j.jad.2010.04.007. Full text in Research Archive

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• Aminoff, Sofie Ragnhild; Henry, Chantal; Bettella, Francesco; Etain, Bruno; Berg, Akiah Ottesen & Lagerberg, Trine Vik [Show all 12 contributors for this article] (2018). Affective lability and polygenic risk in bipolar disorder. Full text in Research Archive
• Aminoff, Sofie Ragnhild; Lagerberg, Trine Vik; Aas, Monica; Bjella, Thomas; Henry, Chantal & Leboyer, Marion [Show all 10 contributors for this article] (2015). Affective lability is Associated With Alcohol use disorders in Bipolar disorder. Full text in Research Archive

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