umalt

• Bjørke, Jeanette Solheimslid; Schøyen, Helle Kristine; Vaaler, Arne Einar; Auestad, Bjørn Henrik; Malt, Ulrik Fredrik & Morken, Gunnar [Vis alle 10 forfattere av denne artikkelen] (2026). Patient-Reported Outcomes From a Randomized Controlled Trial Comparing Right Unilateral Electroconvulsive Therapy With Algorithm-Based Pharmacological Treatment in Bipolar Depression, With Long-Term Follow-Up on Pharmacological Treatment. Bipolar Disorders. ISSN 1398-5647. 28(3). doi: 10.1111/bdi.70105. Fulltekst i vitenarkiv Vis sammendrag

  Objective The objective was to compare acute and long-term patient-reported outcome measures (PROMs) of symptoms and functioning in treatment-resistant bipolar depression following right unilateral (RUL) electroconvulsive therapy (ECT) and algorithm-based pharmacological treatment (APT). Methods Inpatients with treatment-resistant bipolar depression were randomized to 6 weeks of RUL ECT or APT, followed by pharmacological maintenance treatment for 6 months. Three PROMS—the Medical Outcome Short-Form Health Assessment (RAND-36), the Everyday Memory Questionnaire (EMQ-28), and the Patient Global Impression of Improvement (PGI-I)—and the clinician-rated Montgomery and Åsberg Depression Rating Scale (MADRS) were applied pretreatment, posttreatment, and 6 months posttreatment. Group comparisons were performed using linear mixed-effects analysis. Results Seventy-three patients (NRUL ECT = 38, NAPT = 35) were randomized to treatment, of which 44 (NRUL ECT = 23, NAPT = 21) completed acute treatment, and 39 (NRUL ECT = 20, NAPT = 19) completed the 6-month follow-up. Immediately posttreatment, RUL ECT and APT patients showed improvements in seven and three of the eight RAND-36 dimensions, respectively, while improvements on the PGI-I were greater for RUL ECT than for APT patients (2.2 vs. 2.9, p = 0.010) as were those on the MADRS (13.1 vs. 18.1, p = 0.010), with no group difference on the EMQ-28. At 6 months, there were no significant group differences for any measure. EMQ-28 scores improved significantly from pretreatment to the 6-month follow-up only in the RUL ECT group (122.5 vs. 91.6, p < 0.001). Conclusion Two PROMs and the clinician-rated MADRS favored RUL ECT over APT after 6 weeks of treatment. These findings show the acute benefit of RUL ECT in the treatment of bipolar depression.

• Dahl, Johan; Ormstad, Heidi; Aass, Hans Christian; Malt, Ulrik Fredrik & Andreassen, Ole A. (2024). Changes in pain during a depressive episode and relationship to cytokine levels in major depressive disorder. Nordic Journal of Psychiatry. ISSN 0803-9488. 78(3), s. 181–188. doi: 10.1080/08039488.2023.2290654. Fulltekst i vitenarkiv
• Harel, Daphna; Wu, Yin; Levis, Brooke; Fan, Suiqiong; Sun, Ying & Xu, Mingyao [Vis alle 229 forfattere av denne artikkelen] (2024). Comparison of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale and Hospital Anxiety and Depression – Depression subscale scores by administration mode: An individual participant data differential item functioning meta-analysis. Journal of Affective Disorders. ISSN 0165-0327. 361, s. 674–683. doi: 10.1016/j.jad.2024.06.033. Fulltekst i vitenarkiv
• McWhinney, Sean R.; Hlinka, Jaroslav; Bakstein, Eduard; Dietze, Lorielle M. F.; Corkum, Emily L. V. & Abé, Christoph [Vis alle 91 forfattere av denne artikkelen] (2024). Principal component analysis as an efficient method for capturing multivariate brain signatures of complex disorders—ENIGMA study in people with bipolar disorders and obesity. Human Brain Mapping. ISSN 1065-9471. 45(8). doi: 10.1002/hbm.26682. Fulltekst i vitenarkiv Vis sammendrag

  Multivariate techniques better fit the anatomy of complex neuropsychiatric disorders which are characterized not by alterations in a single region, but rather by variations across distributed brain networks. Here, we used principal component analysis (PCA) to identify patterns of covariance across brain regions and relate them to clinical and demographic variables in a large generalizable dataset of individuals with bipolar disorders and controls. We then compared performance of PCA and clustering on identical sample to identify which methodology was better in capturing links between brain and clinical measures. Using data from the ENIGMA-BD working group, we investigated T1-weighted structural MRI data from 2436 participants with BD and healthy controls, and applied PCA to cortical thickness and surface area measures. We then studied the association of principal components with clinical and demographic variables using mixed regression models. We compared the PCA model with our prior clustering analyses of the same data and also tested it in a replication sample of 327 participants with BD or schizophrenia and healthy controls. The first principal component, which indexed a greater cortical thickness across all 68 cortical regions, was negatively associated with BD, BMI, antipsychotic medications, and age and was positively associated with Li treatment. PCA demonstrated superior goodness of fit to clustering when predicting diagnosis and BMI. Moreover, applying the PCA model to the replication sample yielded significant differences in cortical thickness between healthy controls and individuals with BD or schizophrenia. Cortical thickness in the same widespread regional network as determined by PCA was negatively associated with different clinical and demographic variables, including diagnosis, age, BMI, and treatment with antipsychotic medications or lithium. PCA outperformed clustering and provided an easy-to-use and interpret method to study multivariate associations between brain structure and system-level variables.

• Wu, Yin; Levis, Brooke; Daray, Federico M.; Ioannidis, John P. A.; Patten, Scott B. & Cuijpers, Pim [Vis alle 119 forfattere av denne artikkelen] (2023). Comparison of the Accuracy of the 7-Item HADS Depression Subscale and 14-Item Total HADS for Screening for Major Depression: A Systematic Review and Individual Participant Data Meta-Analysis. Psychological Assessment. ISSN 1040-3590. 35(2), s. 94–114. doi: 10.1037/pas0001181. Fulltekst i vitenarkiv
• Zak, Nathalia; Moberget, Torgeir; Bøen, Erlend; Boye, Birgitte; Rygvold, Trine Waage & Malt, Ulrik Fredrik [Vis alle 10 forfattere av denne artikkelen] (2023). Baseline long-term potentiation-like cortical plasticity is associated with longitudinal cortical thinning in healthy adults and in adults with bipolar disorder type II. European Journal of Neuroscience. ISSN 0953-816X. 58(3), s. 2824–2837. doi: 10.1111/ejn.16038. Fulltekst i vitenarkiv Vis sammendrag

  Abstract The precise neurobiological processes underlying cerebral cortical thinning in aging and psychiatric illnesses remain undetermined, yet aging‐ and synaptic dysfunction‐related loss of synapses are potentially important mechanisms. We used long‐term potentiation‐like plasticity of the visual evoked potential as an index of synaptic function in the cortex and hypothesized that plasticity at baseline would be negatively associated with future cortical thinning in healthy adults and in adults with bipolar disorder type II. Thirty‐two healthy adults and 15 adults with bipolar disorder type II underwent electroencephalography‐based measurement of visual evoked potential plasticity and 3T magnetic resonance imaging of the brain at baseline and a follow‐up brain scan on average 2.3 years later. The relationships between visual evoked potential plasticity at baseline and longitudinal cortical thickness changes were examined using Freesurfer and the Permutation Analysis of Linear Models tool. The analyses showed a negative association between the plasticity of the N1 visual evoked potential amplitude at baseline and thinning rate in the medial and lateral parietal and medial occipital cortices in healthy adults and in the right medial occipital cortex in the total sample of healthy adults and adults with bipolar disorder type II, indicating greater thinning over time in subjects with less N1 plasticity ( p FWER  &lt; .05). Although preliminary, the results indicate an association between visual evoked potential plasticity and the future rate of cortical thinning in healthy adults and in bipolar disorder type II, supporting the hypothesis that cortical thinning might be related to synaptic dysfunction.

• Alme, Tomas Nordheim; Andreasson, Anna; Asprusten, Tarjei Tørre; Bakken, Anne Karen; Beadsworth, Michael BJ & Boye, Birgitte [Vis alle 51 forfattere av denne artikkelen] (2023). Chronic fatigue syndromes: real illnesses that people can recover from. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 41(4), s. 372–376. doi: 10.1080/02813432.2023.2235609. Fulltekst i vitenarkiv Vis sammendrag

  The ‘Oslo Chronic Fatigue Consortium’ consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brain's response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation.Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them.

• Mcwhinney, Sean R.; Abé, Christoph; Alda, Martin; Benedetti, Francesco; Bøen, Erlend & Bonnin, Caterina Del Mar [Vis alle 75 forfattere av denne artikkelen] (2023). Mega-analysis of association between obesity and cortical morphology in bipolar disorders: ENIGMA study in 2832 participants. Psychological Medicine. ISSN 0033-2917. 53(14), s. 6743–6753. doi: 10.1017/S0033291723000223. Fulltekst i vitenarkiv Vis sammendrag

  Background: Obesity is highly prevalent and disabling, especially in individuals with severe mental illness including bipolar disorders (BD). The brain is a target organ for both obesity and BD. Yet, we do not understand how cortical brain alterations in BD and obesity interact. Methods: We obtained body mass index (BMI) and MRI-derived regional cortical thickness, surface area from 1231 BD and 1601 control individuals from 13 countries within the ENIGMA-BD Working Group. We jointly modeled the statistical effects of BD and BMI on brain structure using mixed effects and tested for interaction and mediation. We also investigated the impact of medications on the BMI-related associations. Results: BMI and BD additively impacted the structure of many of the same brain regions. Both BMI and BD were negatively associated with cortical thickness, but not surface area. In most regions the number of jointly used psychiatric medication classes remained associated with lower cortical thickness when controlling for BMI. In a single region, fusiform gyrus, about a third of the negative association between number of jointly used psychiatric medications and cortical thickness was mediated by association between the number of medications and higher BMI. Conclusions: We confirmed consistent associations between higher BMI and lower cortical thickness, but not surface area, across the cerebral mantle, in regions which were also associated with BD. Higher BMI in people with BD indicated more pronounced brain alterations. BMI is important for understanding the neuroanatomical changes in BD and the effects of psychiatric medications on the brain.

• Voldsbekk, Irene; Bjørnerud, Atle; Groote, Inge Rasmus; Zak, Nathalia; Roelfs, Daniël & Maximov, Ivan [Vis alle 18 forfattere av denne artikkelen] (2022). Evidence for widespread alterations in cortical microstructure after 32 h of sleep deprivation. Translational Psychiatry. 12(161). doi: 10.1038/s41398-022-01909-x. Fulltekst i vitenarkiv Vis sammendrag

  Cortical microstructure is influenced by circadian rhythm and sleep deprivation, yet the precise underpinnings of these effects remain unclear. The ratio between T1-weighted and T2-weighted magnetic resonance images (T1w/T2w ratio) has been linked to myelin levels and dendrite density and may offer novel insight into the intracortical microstructure of the sleep deprived brain. Here, we examined intracortical T1w/T2w ratio in 41 healthy young adults (26 women) before and after 32 h of either sleep deprivation (n = 18) or a normal sleep-wake cycle (n = 23). Linear models revealed significant group differences in T1w/T2w ratio change after 32 h in four clusters, including bilateral effects in the insular, cingulate, and superior temporal cortices, comprising regions involved in attentional, auditory and pain processing. Across clusters, the sleep deprived group showed an increased T1w/T2w ratio, while the normal sleep-wake group exhibited a reduced ratio. These changes were not explained by in-scanner head movement, and 95% of the effects across clusters remained significant after adjusting for cortical thickness and hydration. Compared with a normal sleep-wake cycle, 32 h of sleep deprivation yields intracortical T1w/T2w ratio increases. While the intracortical changes detected by this study could reflect alterations in myelin or dendritic density, or both, histological analyses are needed to clarify the precise underlying cortical processes.

• Malt, Ulrik Fredrik (2022). Psykiatrisk diagnostikk kan forbedres, men ikke forkastes. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(18), s. 1–2. doi: 10.4045/tidsskr.22.0741. Fulltekst i vitenarkiv
• Brouwer, Rachel M.; Klein, Marieke; Grasby, Katrina L.; Schnack, Hugo G.; Jahanshad, Neda & Teeuw, Jalmar [Vis alle 200 forfattere av denne artikkelen] (2022). Genetic variants associated with longitudinal changes in brain structure across the lifespan. Nature Neuroscience. ISSN 1097-6256. 25(4), s. 421–432. doi: 10.1038/s41593-022-01042-4. Fulltekst i vitenarkiv
• McWhinney, Sean R.; Abé, Christoph; Alda, Martin; Benedetti, Francesco; Bøen, Erlend & Bonnin, Caterina del Mar [Vis alle 75 forfattere av denne artikkelen] (2021). Diagnosis of bipolar disorders and body mass index predict clustering based on similarities in cortical thickness—ENIGMA study in 2436 individuals. Bipolar Disorders. ISSN 1398-5647. s. 1–12. doi: 10.1111/bdi.13172. Fulltekst i vitenarkiv
• Szabo, Attila; O'Connell, Kevin Sean; Ueland, Thor; Sheikh, Mashhood Ahmed; Agartz, Ingrid & Andreou, Dimitrios [Vis alle 31 forfattere av denne artikkelen] (2021). Increased circulating IL-18 levels in severe mental disorders indicate systemic inflammasome activation. Brain, Behavior, and Immunity. ISSN 0889-1591. 99, s. 299–306. doi: 10.1016/j.bbi.2021.10.017. Fulltekst i vitenarkiv Vis sammendrag

  Background Schizophrenia (SCZ) and bipolar disorder (BD) are severe mental illnesses (SMI) that are part of a psychosis continuum, and dysregulated innate immune responses have been suggested to be involved in their pathophysiology. However, disease-specific immune mechanisms in SMI are not known yet. Recently, dyslipidemia has been linked to systemic inflammasome activation, and elevated atherogenic lipid ratios have been shown to correlate with circulating levels of inflammatory biomarkers in SMI. It is, however, not yet known if increased systemic cholesterol load leads to inflammasome activation in these patients. Methods We tested the hypothesis that patients with SCZ and BD display higher circulating levels compared to healthy individuals of key members of the IL-18 system using a large patient cohort (n = 1632; including 737 SCZ and 895 BD), and healthy controls (CTRL; n = 1070). In addition, we assessed associations with coronary artery disease risk factors in SMI, focusing on relevant inflammasome-related, neuroendocrine, and lipid markers. Results We report higher baseline levels of circulating IL-18 system components (IL-18, IL-18BPA, IL-18R1), and increased expression of inflammasome-related genes (NLRP3 and NLRC4) in the blood of patients relative to CTRL. We demonstrate a cholesterol dyslipidemia pattern in psychotic disorders, and report correlations between levels of blood cholesterol types and the expression of inflammasome system elements in SMI. Conclusions Based on these results, we suggest a role for inflammasome activation/dysregulation in SMI. Our findings further the understanding of possible underlying inflammatory mechanisms and may expose important therapeutic targets in SMI.

• Abé, Christoph; Ching, Christopher R.K.; Liberg, Benny; Lebedev, Alexander V.; Agartz, Ingrid & Akudjedu, Theophilus N. [Vis alle 72 forfattere av denne artikkelen] (2021). Longitudinal Structural Brain Changes in Bipolar Disorder: A Multicenter Neuroimaging Study of 1232 Individuals by the ENIGMA Bipolar Disorder Working Group. Biological Psychiatry. ISSN 0006-3223. s. 1–11. doi: 10.1016/j.biopsych.2021.09.008. Fulltekst i vitenarkiv Vis sammendrag

  Background Bipolar disorder (BD) is associated with cortical and subcortical structural brain abnormalities. It is unclear whether such alterations progressively change over time, and how this is related to the number of mood episodes. To address this question, we analyzed a large and diverse international sample with longitudinal magnetic resonance imaging (MRI) and clinical data to examine structural brain changes over time in BD. Methods Longitudinal structural MRI and clinical data from the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) BD Working Group, including 307 patients with BD and 925 healthy control subjects, were collected from 14 sites worldwide. Male and female participants, aged 40 ± 17 years, underwent MRI at 2 time points. Cortical thickness, surface area, and subcortical volumes were estimated using FreeSurfer. Annualized change rates for each imaging phenotype were compared between patients with BD and healthy control subjects. Within patients, we related brain change rates to the number of mood episodes between time points and tested for effects of demographic and clinical variables. Results Compared with healthy control subjects, patients with BD showed faster enlargement of ventricular volumes and slower thinning of the fusiform and parahippocampal cortex (0.18 < d < 0.22). More (hypo)manic episodes were associated with faster cortical thinning, primarily in the prefrontal cortex. Conclusions In the hitherto largest longitudinal MRI study on BD, we did not detect accelerated cortical thinning but noted faster ventricular enlargements in BD. However, abnormal frontocortical thinning was observed in association with frequent manic episodes. Our study yields insights into disease progression in BD and highlights the importance of mania prevention in BD treatment.

• Engh, John; Ueland, Thor; Agartz, Ingrid; Andreou, Dimitrios; Aukrust, Pål & Boye, Birgitte [Vis alle 27 forfattere av denne artikkelen] (2021). Plasma Levels of the Cytokines B Cell-Activating Factor (BAFF) and A Proliferation-Inducing Ligand (APRIL) in Schizophrenia, Bipolar, and Major Depressive Disorder: A Cross Sectional, Multisite Study. Schizophrenia Bulletin. ISSN 0586-7614. 48(1), s. 37–46. doi: 10.1093/schbul/sbab106. Fulltekst i vitenarkiv Vis sammendrag

  Background Immune dysfunction has been implicated in the pathogenesis of schizophrenia and other nonaffective psychosis (SCZ), bipolar spectrum disorder (BIP) and major depressive disorder (MDD). The cytokines B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL) belong to the tumor necrosis factor (TNF) super family and are essential in orchestrating immune responses. Abnormal levels of BAFF and APRIL have been found in autoimmune diseases with CNS affection. Methods We investigated if plasma levels of BAFF and APRIL differed between patients with SCZ, BIP, and MDD with psychotic symptoms (n = 2009) and healthy control subjects (HC, n = 1212), and tested for associations with psychotic symptom load, controlling for sociodemographic status, antipsychotic and other psychotropic medication, smoking, body-mass-index, and high sensitivity CRP. Results Plasma APRIL level was significantly lower across all patient groups compared to HC (P < .001; Cohen’s d = 0.33), and in SCZ compared to HC (P < .001; d = 0.28) and in BIP compared to HC (P < .001; d = 0.37). Lower plasma APRIL was associated with higher psychotic symptom load with nominal significance (P = .017), but not with any other clinical characteristics. Plasma BAFF was not significantly different across patient groups vs HC, but significantly higher in BIP compared to HC (P = .040; d = 0.12) and SCZ (P = .027; d = 0.10). Conclusions These results show aberrant levels of BAFF and APRIL and association with psychotic symptoms in patients with SCZ and BIP. This suggest that dysregulation of the TNF system, mediated by BAFF and APRIL, is involved in the pathophysiology of psychotic disorders.

• McWhinney, Sean R.; Abé, Christoph; Alda, Martin; Benedetti, Francesco; Bøen, Erlend & Bonnin, Caterina del Mar [Vis alle 51 forfattere av denne artikkelen] (2021). Association between body mass index and subcortical brain volumes in bipolar disorders–ENIGMA study in 2735 individuals. Molecular Psychiatry. ISSN 1359-4184. 26(11), s. 6806–6819. doi: 10.1038/s41380-021-01098-x. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Individuals with bipolar disorders (BD) frequently suffer from obesity, which is often associated with neurostructural alterations. Yet, the effects of obesity on brain structure in BD are under-researched. We obtained MRI-derived brain subcortical volumes and body mass index (BMI) from 1134 BD and 1601 control individuals from 17 independent research sites within the ENIGMA-BD Working Group. We jointly modeled the effects of BD and BMI on subcortical volumes using mixed-effects modeling and tested for mediation of group differences by obesity using nonparametric bootstrapping. All models controlled for age, sex, hemisphere, total intracranial volume, and data collection site. Relative to controls, individuals with BD had significantly higher BMI, larger lateral ventricular volume, and smaller volumes of amygdala, hippocampus, pallidum, caudate, and thalamus. BMI was positively associated with ventricular and amygdala and negatively with pallidal volumes. When analyzed jointly, both BD and BMI remained associated with volumes of lateral ventricles  and amygdala. Adjusting for BMI decreased the BD vs control differences in ventricular volume. Specifically, 18.41% of the association between BD and ventricular volume was mediated by BMI ( Z  = 2.73, p  = 0.006). BMI was associated with similar regional brain volumes as BD, including lateral ventricles, amygdala, and pallidum. Higher BMI may in part account for larger ventricles, one of the most replicated findings in BD. Comorbidity with obesity could explain why neurostructural alterations are more pronounced in some individuals with BD. Future prospective brain imaging studies should investigate whether obesity could be a modifiable risk factor for neuroprogression.

• Andreou, Dimitrios; Steen, Nils Eiel; Jørgensen, Kjetil Nordbø; Smelror, Runar; Wedervang-Resell, Kirsten & Nerland, Stener [Vis alle 25 forfattere av denne artikkelen] (2021). Lower circulating neuron-specific enolase concentrations in adults and adolescents with severe mental illness. Psychological Medicine. ISSN 0033-2917. s. 1–10. doi: 10.1017/S0033291721003056. Fulltekst i vitenarkiv Vis sammendrag

  Background Both neurodegenerative and neurodevelopmental abnormalities have been suggested to be part of the etiopathology of severe mental illness (SMI). Neuron-specific enolase (NSE), mainly located in the neuronal cytoplasm, may indicate the process as it is upregulated after neuronal injury while a switch from non-neuronal enolase to NSE occurs during neuronal maturation. Methods We included 1132 adult patients with SMI [schizophrenia (SZ) or bipolar spectrum disorders], 903 adult healthy controls (HC), 32 adolescent patients with SMI and 67 adolescent HC. Plasma NSE concentrations were measured by enzyme immunoassay. For 842 adults and 85 adolescents, we used total grey matter volume (TGMV) based on T1-weighted magnetic resonance images processed in FreeSurfer v6.0. We explored NSE case-control differences in adults and adolescents separately. To investigate whether putative case-control differences in NSE were TGMV-dependent we controlled for TGMV. Results We found significantly lower NSE concentrations in both adult (p < 0.001) and adolescent patients with SMI (p = 0.007) compared to HC. The results remained significant after controlling for TGMV. Among adults, both patients with SZ spectrum (p < 0.001) and bipolar spectrum disorders (p = 0.005) had lower NSE than HC. In both patient subgroups, lower NSE levels were associated with increased symptom severity. Among adults (p < 0.001) and adolescents (p = 0.040), females had lower NSE concentrations than males. Conclusion We found lower NSE concentrations in adult and adolescent patients with SMI compared to HC. The results suggest the lack of progressive neuronal injury, and may reflect abnormal neuronal maturation. This provides further support of a neurodevelopmental rather than a neurodegenerative mechanism in SMI.

• Bürker, Britta Susanne; Malt, Ulrik Fredrik; Gude, Einar; Grov, Ingelin; Relbo, Anne & Dew, Mary Amanda [Vis alle 7 forfattere av denne artikkelen] (2021). Symptoms of anxiety after heart transplantation and their association with mortality: A secondary analysis. Clinical Transplantation. ISSN 0902-0063. 35(7), s. 1–7. doi: 10.1111/ctr.14323. Fulltekst i vitenarkiv
• Han, Laura KM; Dinga, Richard; Hahn, Tim; Ching, Christopher R. K.; Eyler, Lisa T. & Aftanas, Lyubomir [Vis alle 50 forfattere av denne artikkelen] (2020). Brain aging in major depressive disorder: results from the ENIGMA major depressive disorder working group. Molecular Psychiatry. ISSN 1359-4184. doi: 10.1038/s41380-020-0754-0. Fulltekst i vitenarkiv Vis sammendrag

  Major depressive disorder (MDD) is associated with an increased risk of brain atrophy, aging-related diseases, and mortality. We examined potential advanced brain aging in adult MDD patients, and whether this process is associated with clinical characteristics in a large multicenter international dataset. We performed a mega-analysis by pooling brain measures derived from T1-weighted MRI scans from 19 samples worldwide. Healthy brain aging was estimated by predicting chronological age (18–75 years) from 7 subcortical volumes, 34 cortical thickness and 34 surface area, lateral ventricles and total intracranial volume measures separately in 952 male and 1236 female controls from the ENIGMA MDD working group. The learned model coefficients were applied to 927 male controls and 986 depressed males, and 1199 female controls and 1689 depressed females to obtain independent unbiased brain-based age predictions. The difference between predicted “brain age” and chronological age was calculated to indicate brain-predicted age difference (brain-PAD). On average, MDD patients showed a higher brain-PAD of +1.08 (SE 0.22) years (Cohen’s d = 0.14, 95% CI: 0.08–0.20) compared with controls. However, this difference did not seem to be driven by specific clinical characteristics (recurrent status, remission status, antidepressant medication use, age of onset, or symptom severity). This highly powered collaborative effort showed subtle patterns of age-related structural brain abnormalities in MDD. Substantial within-group variance and overlap between groups were observed. Longitudinal studies of MDD and somatic health outcomes are needed to further assess the clinical value of these brain-PAD estimates.

• Søyseth, Torunn Stavnes; Dew, Mary Amanda; Samersaw-Lund, May Brit; Haugstad, Gro Killi; Søyseth, Vidar & Malt, Ulrik Fredrik (2020). Coping Patterns and Emotional Distress in Patients With Chronic Obstructive Lung Disease Who Are Undergoing Lung Transplant Evaluation. Progress in transplantation. ISSN 1526-9248. 30(3), s. 228–234. doi: 10.1177/1526924820933817. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Living with severe lung disease like chronic obstructive pulmonary disease (COPD) is a very stressful situation. The way patients cope may impact their symptoms of anxiety and depression and physical function as well. We studied how ways of coping are associated with levels of emotional distress and lung function in patients with COPD being evaluated for lung transplantation. Methods: Sixty-five (mean age 57 years, 46% females) patients completed the General Health Questionnaire-30 (GHQ-30) assessing emotional distress and the Ways of Coping Questionnaire. Measurements of lung function and 6-minute walk test were included. Results: Seventeen (26%) patients had elevated emotional distress. Logistic regression of chronic GHQ score with gender, age, body mass index, lung function, and coping scales as covariates showed that escape avoidance and selfcontrolling coping and forced vital lung capacity were significantly associated with high emotional distress. Odds ratio of emotional distress increased with 5.2 per tertile (P ¼ .011) in escape avoidance coping score. Moreover, we revealed that emotionally distressed patients cope with their current situation by refusing to believe the current situation and taking their distress out on other people. Conclusion: Among patients with COPD, a high level of emotional distress was uniquely associated with escapeavoidance coping and lung function. Future work should ascertain whether coping style predicts distress or whether distress increases the use of escape-avoidance coping. Nevertheless, our findings indicate that if either element is present, health care professionals should be attentive to the need for interventions to improve patients’ well-being.

• Wasserman, Danuta; Apter, G.; Baeken, C.; Bailey, S.; Balazs, Judit & Bec, C. [Vis alle 86 forfattere av denne artikkelen] (2020). Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries. European psychiatry. ISSN 0924-9338. 63(1), s. 1–9. doi: 10.1192/j.eurpsy.2020.79. Fulltekst i vitenarkiv Vis sammendrag

  Background. Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care. Methods. The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions. Results. We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures. Conclusions. We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

• Bøen, Erlend; Hummelen, Benjamin; Boye, Birgitte; Elvsåshagen, Torbjørn & Malt, Ulrik Fredrik (2020). Borderline patients have difficulties describing feelings; bipolar II patients describe difficult feelings. An alexithymia study. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 142(3), s. 203–214. doi: 10.1111/acps.13204. Fulltekst i vitenarkiv
• Drange, Ole Kristian; Sæther, Sverre Georg; Finseth, Per Ivar; Morken, Gunnar; Vaaler, Arne & Arntsen, Vibeke [Vis alle 11 forfattere av denne artikkelen] (2020). Differences in course of illness between patients with bipolar II disorder with and without epileptiform discharges or other sharp activity on electroencephalograms: a cross-sectional study. BMC Psychiatry. 20. doi: 10.1186/s12888-020-02968-4. Fulltekst i vitenarkiv Vis sammendrag

  Background A diagnosis of bipolar II disorder requires that the symptoms cannot be better explained by a medical condition. Epilepsy is in some cases associated with an affective syndrome mimicking an unstable bipolar II disorder. Epileptiform discharges on electroencephalograms (EEGs) are typical, but not pathognomonic, for epilepsy. A previous study has found a high frequency of epileptiform discharges and other sharp activity among patients with bipolar disorder. The aim of the study was to identify if epileptic discharges or other sharp activity per se are associated with an altered course of illness among patients with bipolar II disorder. Methods Eighty six patients diagnosed with bipolar II disorder at two psychiatric departments were interviewed about prior course of illness and assessed with EEGs. The patients were split into two groups based on the presence (n = 12) or absence (n = 74) of epileptiform discharges or other sharp activity. Wilcoxon rank sum test, Fisher’s exact test, and Pearson’s chi squared test were used to assess differences between the groups on six variables of course of illness. Results Patients with epileptiform discharges or other sharp activity had a history of more hypomanic episodes per year (median (interquartile range (IQR)) 1.5 (3.2) vs. 0.61 (1.1), p = 0.0090) and a higher hypomania:depression ratio (median (IQR) 3.2 (16) vs. 1.0 (1.0), p = 0.00091) as compared to patients without. None of the patients with epileptiform discharges or other sharp activity had self-reported epileptic seizures in their history. Conclusions Epileptiform discharges or other sharp activity on EEGs are associated with more hypomanic episodes and an increased hypomania:depression ratio. Our results warrant replication in prospective studies, but suggest that EEG findings could be of prognostic importance for patients diagnosed with bipolar II disorder in psychiatric care.

• Elvsåshagen, Torbjørn; Bahrami, Shahram; Meer, Dennis van der; Agartz, Ingrid; Alnæs, Dag & Barch, Deanna M. [Vis alle 76 forfattere av denne artikkelen] (2020). The genetic architecture of human brainstem structures and their involvement in common brain disorders. Nature Communications. 11. doi: 10.1038/s41467-020-17376-1. Fulltekst i vitenarkiv Vis sammendrag

  Brainstem regions support vital bodily functions, yet their genetic architectures and involvement in common brain disorders remain understudied. Here, using imaging-genetics data from a discovery sample of 27,034 individuals, we identify 45 brainstem-associated genetic loci, including the first linked to midbrain, pons, and medulla oblongata volumes, and map them to 305 genes. In a replication sample of 7432 participants most of the loci show the same effect direction and are significant at a nominal threshold. We detect genetic overlap between brainstem volumes and eight psychiatric and neurological disorders. In additional clinical data from 5062 individuals with common brain disorders and 11,257 healthy controls, we observe differential volume alterations in schizophrenia, bipolar disorder, multiple sclerosis, mild cognitive impairment, dementia, and Parkinson’s disease, supporting the relevance of brainstem regions and their genetic architectures in common brain disorders.

• Haukvik, Unn Kristin H.; Gurholt, Tiril Pedersen; Nerland, Stener; Elvsåshagen, Torbjørn; Akudjedu, Theophilus N. & Alda, Martin [Vis alle 97 forfattere av denne artikkelen] (2020). In vivo hippocampal subfield volumes in bipolar disorder—A mega‐analysis from The Enhancing Neuro Imaging Genetics through Meta‐Analysis Bipolar Disorder Working Group. Human Brain Mapping. ISSN 1065-9471. 43, s. 385–398. doi: 10.1002/hbm.25249. Fulltekst i vitenarkiv Vis sammendrag

  The hippocampus consists of anatomically and functionally distinct subfields that may be differentially involved in the pathophysiology of bipolar disorder (BD). Here we, the Enhancing NeuroImaging Genetics through Meta‐Analysis Bipolar Disorder workinggroup, study hippocampal subfield volumetry in BD. T1‐weighted magnetic resonance imaging scans from 4,698 individuals (BD = 1,472, healthy controls [HC] = 3,226) from 23 sites worldwide were processed with FreeSurfer. We used linear mixed‐effects models and mega‐analysis to investigate differences in hippocampal subfield volumes between BD and HC, followed by analyses of clinical characteristics and medication use. BD showed significantly smaller volumes of the whole hippocampus (Cohen's d = −0.20), cornu ammonis (CA)1 (d = −0.18), CA2/3 (d = −0.11), CA4 (d = −0.19), molecular layer (d = −0.21), granule cell layer of dentate gyrus (d = −0.21), hippocampal tail (d = −0.10), subiculum (d = −0.15), presubiculum (d = −0.18), and hippocampal amygdala transition area (d = −0.17) compared to HC. Lithium users did not show volume differences compared to HC, while non‐users did. Antipsychotics or antiepileptic use was associated with smaller volumes. In this largest study of hippocampal subfields in BD to date, we show widespread reductions in nine of 12 subfields studied. The associations were modulated by medication use and specifically the lack of differences between lithium users and HC supports a possible protective role of lithium in BD.

• Mikkelsen, Audun; Boye, Birgitte; Diseth, Trond H; Malt, Ulrik Fredrik; Mørkrid, Lars & Ijsselstijn, Hanneke [Vis alle 7 forfattere av denne artikkelen] (2020). Traumatic stress, mental health and quality of life in adolescents with esophageal atresia. Journal of Pediatric Surgery. ISSN 0022-3468. 15(26), s. 1–9. doi: 10.1016/j.jpedsurg.2020.10.029. Fulltekst i vitenarkiv Vis sammendrag

  Introduction We aimed to investigate QoL in EA patients in relation to comparison groups and to clinical factors including experienced traumatic stress. Material and Methods Adolescents with EA in Norway born between 1996 and 2002 were included. Clinical assessment and patient's characteristics were collected. Quality of life (PedsQL), traumatic stress (IES-13) and mental health (SDQ-20) were compared to groups of healthy controls, children with acute lymphoblastic leukemia (ALL) and kidney transplanted children (TX). Results 68 EA adolescents participated. Total scores for PedsQL were not different from the healthy group and ALL patients, but significantly better than the TX patients. The subscale for physical performance was significantly lower than in healthy adolescents, and nine (17%) patients had scores ≤70 indicating reduced health status. Five EA adolescents (12%) had mental health scores suggesting a psychiatric disorder, and six (9%) reported high traumatic stress scores with a significant correlation to days on ventilator in the neonatal period. The strongest predictors for quality of life among EA adolescents were self-reported mental health, posttraumatic stress and GERD symptoms. Conclusion Scores for Quality of life in the EA group are good except for subscale for physical performance. Symptoms of posttraumatic stress, mental strain and gastroesophageal reflux are predictors of reduced QoL.

• Kvello, Morten; Åvitsland, Tone Lise; Knatten, Charlotte Kristensen; Fyhn, Thomas Johan; Malt, Ulrik Fredrik & Emblem, Ragnhild [Vis alle 7 forfattere av denne artikkelen] (2019). Psychologic Distress and Anxiety in Mothers of Children With Gastroesophageal Reflux Undergoing Antireflux Surgery. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 68(6), s. 818–823. doi: 10.1097/MPG.0000000000002286. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Parents of children with a chronic illness are at risk for impaired psychosocial functioning. Gastroesophageal reflux disease (GERD) is such a disease, and no studies have investigated effects of antireflux surgery on parental psychological distress. The aims of this study were to assess psychological distress and state and trait anxiety in mothers of children with GERD, and to explore possible changes after antireflux surgery. Methods: Mothers of children referred for antireflux surgery were included in this prospective study. Standardized questionnaires were used to evaluate psychological distress and state and trait anxiety before and 12 months after antireflux surgery. Results: Of 87 eligible mothers of children with GERD, 62 (71%) agreed to participate. All children had objectively verified GERD by 24-hour pH-monitoring and/or upper gastrointestinal contrast study and unsatisfactory symptom relief of pharmacological treatment. Thirty-one (50%) mothers returned questionnaires postoperatively. Preoperatively, mothers of children undergoing antireflux surgery reported high levels of psychological distress and state anxiety, and 54% had scores indicating clinically significant psychological distress. None of the preoperative child characteristics were found to significantly influence maternal psychological distress or state anxiety. Twelve months postoperatively, both psychological distress and state anxiety were reduced. Conclusions: Mothers of children undergoing antireflux surgery reported reduced levels of psychological distress and state anxiety 12 months after the operation.

• Bøen, Erlend; Hjornevik, Trine; Hummelen, Benjamin; Elvsåshagen, Torbjørn; Moberget, Torgeir & Holtedahl, Jon Erik [Vis alle 10 forfattere av denne artikkelen] (2019). Patterns of altered regional brain glucose metabolism in borderline personality disorder and bipolar II disorder. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 139(3), s. 256–268. doi: 10.1111/acps.12997. Fulltekst i vitenarkiv
• Zak, Nathalia; Bøen, Erlend; Boye, Birgitte; Andreassen, Ole Andreas; Doan, Nhat Trung & Malt, Ulrik Fredrik [Vis alle 8 forfattere av denne artikkelen] (2019). Mood episodes are associated with increased cortical thinning: A longitudinal study of bipolar disorder type II. Bipolar Disorders. ISSN 1398-5647. 21, s. 525–538. doi: 10.1111/bdi.12771. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Previous studies found evidence for thinner frontotemporal cortices in bipolar disorder (BD), yet whether this represents a stable disease trait or an effect of mood episodes remains unknown. Here, we assessed the reproducibility of thinner frontotemporal cortices in BD type II, compared longitudinal changes in cortical thickness between individuals with BD type II and healthy controls (HCs), and examined the effect of mood episodes on cortical thickness change. Methods Thirty‐three HCs and 29 individuals with BD type II underwent 3T magnetic resonance imaging at baseline, as published previously, and 2.4 years later, at follow‐up. Cross‐sectional and longitudinal analyses of cortical thickness were performed using Freesurfer, and relationships with mood episodes from baseline to follow‐up were assessed. Results Individuals with BD type II had thinner left and right prefrontal and left temporal cortex clusters at follow‐up (all corrected P < 0.001), consistent with baseline results. Both groups showed widespread longitudinal cortical thinning, and patients had increased thinning in a left temporal cortex cluster compared to HCs (corrected P < 0.001). Patients with more (>2) depressive episodes between baseline and follow‐up had greater left temporal cortical thinning than patients with fewer depressive episodes (corrected P < 0.05). In addition, patients with more depressive episodes had greater thinning in bilateral ventromedial prefrontal clusters relative to HCs (uncorrected P < 0.05), yet these results did not survive correction for multiple comparisons. Conclusions Together, these findings support reduced frontotemporal cortical thickness in BD type II and provide the first preliminary evidence for an association between depressive episodes and increased cortical thinning.

• Kaufmann, Tobias; Meer, Dennis van der; Doan, Nhat Trung; Schwarz, Emanuel; Lund, Martina Jonette & Agartz, Ingrid [Vis alle 84 forfattere av denne artikkelen] (2019). Common brain disorders are associated with heritable patterns of apparent aging of the brain. Nature Neuroscience. ISSN 1097-6256. 22(10), s. 1617–1623. doi: 10.1038/s41593-019-0471-7. Fulltekst i vitenarkiv Vis sammendrag

  Common risk factors for psychiatric and other brain disorders are likely to converge on biological pathways influencing the development and maintenance of brain structure and function across life. Using structural MRI data from 45,615 individuals aged 3–96 years, we demonstrate distinct patterns of apparent brain aging in several brain disorders and reveal genetic pleiotropy between apparent brain aging in healthy individuals and common brain disorders.

• Bürker, Britta Susanne; Gullestad, Lars; Gude, Einar; Havik, Odd E.; Relbo, Anne & Grov, Ingelin [Vis alle 12 forfattere av denne artikkelen] (2019). The predictive value of depression in the years after heart transplantation for mortality during long-term follow-up. Psychosomatic Medicine. ISSN 0033-3174. 81(6), s. 513–520. doi: 10.1097/PSY.0000000000000702. Fulltekst i vitenarkiv Vis sammendrag

  Objective Current understanding of the prognostic impact of depression on mortality after heart transplantation (HTx) is limited. We examined whether depression after HTx is a predictor of mortality during extended follow-up. Subsequently, we explored whether different symptom dimensions of depression could be identified and whether they were differentially associated with mortality. Methods Survival analyses were performed in a sample of 141 HTx recipients assessed for depression, measured by self-report of depressive symptoms (Beck Depression Inventory – version 1A [BDI-1A]), at median 5.0 years after HTx, and followed thereafter for survival status for up to 18.6 years. We used uni- and multivariate Cox proportional hazard models to examine the association of clinically significant depression (BDI-1A total score ≥10), as well as the cognitive-affective and the somatic subscales of the BDI-1A (resulting from principal component analysis) with mortality. In the multivariate analyses, we adjusted for relevant sociodemographic and clinical variables. Results Clinically significant depression was a significant predictor of mortality (hazard ratio = 2.088; 95% confidence interval = 1.366–3.192; p = .001). Clinically significant depression also was an independent predictor of mortality in the multivariate analysis (hazard ratio = 1.982; 95% confidence interval = 1.220–3.217; p = .006). The somatic subscale, but not the cognitive-affective subscale, was significantly associated with increased mortality in univariate analyses, whereas neither of the two subscales was an independent predictor of mortality in the multivariate analysis. Conclusions Depression measured by self-report after HTx is associated with increased mortality during extended follow-up. Clinical utility and predictive validity of specific depression components require further study.

• Lee, Phil H.; Antilla, Verneri; Won, Hyejung; Feng, Yen-Chen A.; Rosenthal, Jacob & Zhu, Zhaozhong [Vis alle 66 forfattere av denne artikkelen] (2019). Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders. Cell. ISSN 0092-8674. 179(7), s. 1469–1482. doi: 10.1016/j.cell.2019.11.020. Fulltekst i vitenarkiv Vis sammendrag

  Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed a meta-analysis of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyperactivity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders identifying three groups of inter-related disorders. We detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning in the second trimester prenatally, and play prominent roles in a suite of neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.

• Hibar, Derrek; Westlye, Lars Tjelta; Doan, Nhat Trung; Jahanshad, Neda; Cheung, J. W. & Ching, Christopher R K [Vis alle 123 forfattere av denne artikkelen] (2018). Cortical abnormalities in bipolar disorder: An MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Molecular Psychiatry. ISSN 1359-4184. 23, s. 932–942. doi: 10.1038/mp.2017.73. Fulltekst i vitenarkiv Vis sammendrag

  Despite decades of research, the pathophysiology of bipolar disorder (BD) is still not well understood. Structural brain differences have been associated with BD, but results from neuroimaging studies have been inconsistent. To address this, we performed the largest study to date of cortical gray matter thickness and surface area measures from brain magnetic resonance imaging scans of 6503 individuals including 1837 unrelated adults with BD and 2582 unrelated healthy controls for group differences while also examining the effects of commonly prescribed medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions. In BD, cortical gray matter was thinner in frontal, temporal and parietal regions of both brain hemispheres. BD had the strongest effects on left pars opercularis (Cohen’s d=−0.293; P=1.71 × 10−21), left fusiform gyrus (d=−0.288; P=8.25 × 10−21) and left rostral middle frontal cortex (d=−0.276; P=2.99 × 10−19). Longer duration of illness (after accounting for age at the time of scanning) was associated with reduced cortical thickness in frontal, medial parietal and occipital regions. We found that several commonly prescribed medications, including lithium, antiepileptic and antipsychotic treatment showed significant associations with cortical thickness and surface area, even after accounting for patients who received multiple medications. We found evidence of reduced cortical surface area associated with a history of psychosis but no associations with mood state at the time of scanning. Our analysis revealed previously undetected associations and provides an extensive analysis of potential confounding variables in neuroimaging studies of BD.

• Consorti, Bipolar Sczhizophrenia Psychiatric Genomics; Ruderfer, Douglas M.; Ripke, Stephan; McQuillin, Andrew; Boocock, James & Stahl, Eli A. [Vis alle 52 forfattere av denne artikkelen] (2018). Genomic Dissection of Bipolar Disorder and Schizophrenia, Including 28 Subphenotypes. Cell. ISSN 0092-8674. 173(7), s. 1705–1715. doi: 10.1016/j.cell.2018.05.046. Fulltekst i vitenarkiv
• Drange, Ole Kristian; Vaaler, Arne; Morken, Gunnar; Andreassen, Ole Andreas; Malt, Ulrik Fredrik & Finseth, Per Ivar (2018). Clinical characteristics of patients with bipolar disorder and premorbid traumatic brain injury: a cross-sectional study. International journal of bipolar disorders. 6(19). doi: 10.1186/s40345-018-0128-6. Fulltekst i vitenarkiv Vis sammendrag

  Background About one in ten diagnosed with bipolar disorder (BD) has experienced a premorbid traumatic brain injury (TBI), while not fulfilling the criteria of bipolar and related disorder due to another medical condition (BD due to TBI). We investigated whether these patients have similar clinical characteristics as previously described in BD due to TBI (i.e. more aggression and irritability and an increased hypomania/mania:depression ratio) and other distinct clinical characteristics. Methods Five hundred five patients diagnosed with BD type I, type II, or not otherwise specified, or cyclothymia were interviewed about family, medical, and psychiatric history, and assessed with the Young Mania Rating Scale (YMRS) and the Inventory of Depressive Symptoms Clinician Rated 30 (IDS-C30). Principal component analyses of YMRS and IDS-C30 were conducted. Bivariate analyses and logistic regression analyses were used to compare clinical characteristics between patients with (n = 37) and without (n = 468) premorbid TBI. Results Premorbid TBI was associated with a higher YMRS disruptive component score (OR 1.7, 95% CI 1.1–2.4, p = 0.0077) and more comorbid migraine (OR 4.6, 95% CI 1.9–11, p = 0.00090) independently of several possible confounders. Items on disruptive/aggressive behaviour and irritability had the highest loadings on the YMRS disruptive component. Premorbid TBI was not associated with an increased hypomania/mania:depression ratio. Conclusions Disruptive symptoms and comorbid migraine characterize BD with premorbid TBI. Further studies should examine whether the partial phenomenological overlap with BD due to TBI could be explained by a continuum of pathophysiological effects of TBI across the diagnostic dichotomy.

• Feltz-Cornelis, Christina M. van der; Elfeddali, Iman; Werneke, Ursula; Malt, Ulrik Fredrik; Bergh, Omer Van den & Schaefert, Rainer [Vis alle 11 forfattere av denne artikkelen] (2018). A European research agenda for somatic symptom disorders, bodily distress disorders, and functional disorders: Results of an estimate-talk-estimate delphi expert study. Frontiers in Psychiatry. 9:151(MAY), s. 1–19. doi: 10.3389/fpsyt.2018.00151. Fulltekst i vitenarkiv Vis sammendrag

  Background: Somatic Symptom Disorders (SSD), Bodily Distress Disorders (BDD) and functional disorders (FD) are associated with high medical and societal costs and pose a substantial challenge to the population and health policy of Europe. To meet this challenge, a specific research agenda is needed as one of the cornerstones of sustainable mental health research and health policy for SSD, BDD, and FD in Europe. Aim: To identify the main challenges and research priorities concerning SSD, BDD, and FD from a European perspective. Methods: Delphi study conducted from July 2016 until October 2017 in 3 rounds with 3 workshop meetings and 3 online surveys, involving 75 experts and 21 European countries. EURONET-SOMA and the European Association of Psychosomatic Medicine (EAPM) hosted the meetings. Results: Eight research priorities were identified: (1) Assessment of diagnostic profiles relevant to course and treatment outcome. (2) Development and evaluation of new, effective interventions. (3) Validation studies on questionnaires or semi-structured interviews that assess chronic medical conditions in this context. (4) Research into patients preferences for diagnosis and treatment. (5) Development of new methodologic designs to identify and explore mediators and moderators of clinical course and treatment outcomes (6). Translational research exploring how psychological and somatic symptoms develop from somatic conditions and biological and behavioral pathogenic factors. (7) Development of new, effective interventions to personalize treatment. (8) Implementation studies of treatment interventions in different settings, such as primary care, occupational care, general hospital and specialty mental health settings. The general public and policymakers will benefit from the development of new, effective, personalized interventions for SSD, BDD, and FD, that will be enhanced by translational research, as well as from the outcomes of research into patient involvement, GP-patient communication, consultation-liaison models and implementation. Conclusion: Funding for this research agenda, targeting these challenges in coordinated research networks such as EURONET-SOMA and EAPM, and systematically allocating resources by policymakers to this critical area in mental and physical well-being is urgently needed to improve efficacy and impact for diagnosis and treatment of SSD, BDD, and FD across Europe.

• Kong, Xiang-Zhen; Mathias, Samuel R.; Guadalupe, Tulio; Agartz, Ingrid; Andreassen, Ole Andreas & Bøen, Erlend [Vis alle 33 forfattere av denne artikkelen] (2018). Mapping cortical brain asymmetry in 17,141 healthy individuals worldwide via the ENIGMA Consortium. Proceedings of the National Academy of Sciences of the United States of America (PNAS). ISSN 0027-8424. 115(22), s. E5154–E5163. doi: 10.1073/pnas.1718418115. Fulltekst i vitenarkiv
• Nunes, Abraham; Schnack, Hugo G.; Ching, Christopher R.K.; Agartz, Ingrid; Akudjedu, Theophilus N. & Alda, Martin [Vis alle 74 forfattere av denne artikkelen] (2018). Using structural MRI to identify bipolar disorders ? 13 site machine learning study in 3020 individuals from the ENIGMA Bipolar Disorders Working Group. Molecular Psychiatry. ISSN 1359-4184. doi: 10.1038/s41380-018-0228-9. Fulltekst i vitenarkiv Vis sammendrag

  Bipolar disorders (BDs) are among the leading causes of morbidity and disability. Objective biological markers, such as those based on brain imaging, could aid in clinical management of BD. Machine learning (ML) brings neuroimaging analyses to individual subject level and may potentially allow for their diagnostic use. However, fair and optimal application of ML requires large, multi-site datasets. We applied ML (support vector machines) to MRI data (regional cortical thickness, surface area, subcortical volumes) from 853 BD and 2167 control participants from 13 cohorts in the ENIGMA consortium. We attempted to differentiate BD from control participants, investigated different data handling strategies and studied the neuroimaging/clinical features most important for classification. Individual site accuracies ranged from 45.23% to 81.07%. Aggregate subject-level analyses yielded the highest accuracy (65.23%, 95% CI = 63.47–67.00, ROC-AUC = 71.49%, 95% CI = 69.39–73.59), followed by leave-one-site-out cross-validation (accuracy = 58.67%, 95% CI = 56.70–60.63). Meta-analysis of individual site accuracies did not provide above chance results. There was substantial agreement between the regions that contributed to identification of BD participants in the best performing site and in the aggregate dataset (Cohen’s Kappa = 0.83, 95% CI = 0.829–0.831). Treatment with anticonvulsants and age were associated with greater odds of correct classification. Although short of the 80% clinically relevant accuracy threshold, the results are promising and provide a fair and realistic estimate of classification performance, which can be achieved in a large, ecologically valid, multi-site sample of BD participants based on regional neurostructural measures. Furthermore, the significant classification in different samples was based on plausible and similar neuroanatomical features. Future multi-site studies should move towards sharing of raw/voxelwise neuroimaging data.

• Elvsåshagen, Torbjørn; Mutsaerts, Henri J.M.M; Zak, Nathalia; Norbom, Linn Christin Bonaventure; Quiraishi, Sophia & Pedersen, Per Øystein Heiberg [Vis alle 11 forfattere av denne artikkelen] (2018). Cerebral blood flow changes after a day of wake, sleep, and sleep deprivation. NeuroImage. ISSN 1053-8119. 186, s. 497–509. doi: 10.1016/j.neuroimage.2018.11.032. Fulltekst i vitenarkiv Vis sammendrag

  Elucidating the neurobiological effects of sleep and wake is an important goal of the neurosciences. Whether and how human cerebral blood flow (CBF) changes during the sleep-wake cycle remain to be clarified. Based on the synaptic homeostasis hypothesis of sleep and wake, we hypothesized that a day of wake and a night of sleep deprivation would be associated with gray matter resting CBF (rCBF) increases and that sleep would be associated with rCBF decreases. Thirty-eight healthy adult males (age 22.1 ± 2.5 years) underwent arterial spin labeling perfusion magnetic resonance imaging at three time points: in the morning after a regular night's sleep, the evening of the same day, and the next morning, either after total sleep deprivation (n = 19) or a night of sleep (n = 19). All analyses were adjusted for hematocrit and head motion. rCBF increased from morning to evening and decreased after a night of sleep. These effects were most prominent in bilateral hippocampus, amygdala, thalamus, and in the occipital and sensorimotor cortices. Group × time interaction analyses for evening versus next morning revealed significant interaction in bilateral lateral and medial occipital cortices and in bilateral insula, driven by rCBF increases in the sleep deprived individuals and decreases in the sleepers, respectively. Furthermore, group × time interaction analyses for first morning versus next morning showed significant effects in medial and lateral occipital cortices, in anterior cingulate gyrus, and in the insula, in both hemispheres. These effects were mainly driven by CBF increases from TP1 to TP3 in the sleep deprived individuals. There were no associations between the rCBF changes and sleep characteristics, vigilant attention, or subjective sleepiness that remained significant after adjustments for multiple analyses. Altogether, these results encourage future studies to clarify mechanisms underlying sleep-related rCBF changes.

• Zak, Nathalia; Moberget, Torgeir; Bøen, Erlend; Boye, Birgitte; Waage, Trine Rygvold & Dietrichs, Espen [Vis alle 12 forfattere av denne artikkelen] (2018). Longitudinal and cross-sectional investigations of long-term potentiation-like cortical plasticity in bipolar disorder type II and healthy individuals. Translational Psychiatry. 8(103). doi: 10.1038/s41398-018-0151-5. Fulltekst i vitenarkiv Vis sammendrag

  Visual evoked potential (VEP) plasticity is a promising assay for noninvasive examination of long-term potentiation (LTP)-like synaptic processes in the cerebral cortex. We conducted longitudinal and cross-sectional investigations of VEP plasticity in controls and individuals with bipolar disorder (BD) type II. VEP plasticity was assessed at baseline, as described previously (Elvsåshagen et al. Biol Psychiatry 2012), and 2.2 years later, at follow-up. The longitudinal sample with VEP data from both time points comprised 29 controls and 16 patients. VEP data were available from 13 additional patients at follow-up (total n = 58). VEPs were evoked by checkerboard reversals in two premodulation blocks before and six blocks after a plasticity-inducing block of prolonged (10 min) visual stimulation. VEP plasticity was computed by subtracting premodulation VEP amplitudes from postmodulation amplitudes. Saliva samples for cortisol analysis were collected immediately after awakening in the morning, 30 min later, and at 12:30 PM, at follow-up. We found reduced VEP plasticity in BD type II, that impaired plasticity was present in the euthymic phases of the illness, and that VEP plasticity correlated negatively with depression severity. There was a positive association between VEP plasticity and saliva cortisol in controls, possibly reflecting an inverted U-shaped relationship between cortisol and synaptic plasticity. VEP plasticity exhibited moderate temporal stability over a period of 2.2 years. The present study provides additional evidence for impaired LTP-like cortical plasticity in BD type II. VEP plasticity is an accessible method, which may help elucidate the pathophysiological and clinical significance of synaptic dysfunction in psychiatric disorders.

• Bjørge, Heidi; Notland, T.H.; Boye, Birgitte; Ulstein, Ingun; Smeby, Nina Aarhus & Malt, Ulrik Fredrik [Vis alle 7 forfattere av denne artikkelen] (2017). How do Patients with Schizophrenia Perceive Relatives’ Levels of Expressed Emotions? A Brief Patient Rated Scale. Open Journal of Psychiatry. ISSN 2161-7325. 7(3). doi: 10.4236/ojpsych.2017.73020. Fulltekst i vitenarkiv Vis sammendrag

  Background: Patients’ perspective on relatives’ attitude and behaviour towards them (Expressed emotion―EE) may be an important addition to the current focus on relatives’ perspective only, as measured by Camberwell Family Interview (CFI) or other methods. Based on the theory of EE, we have designed a brief, three-item questionnaire completed by patients, named Felt Expressed Emotion Rating Scale (FEERS). FEERS measures the patient’s experience of criticism (Cri) and emotional over involvement (i.e. worry (Wo), and control (Con). Aims: To investigate the test-retest reliability of the FEERS and associations between the FEERS and the CFI and to which extent FEERS scores were modified by severity of psychotic symptoms, cognitive function, patient mood and amount of face-to-face contact with relatives. Methods: Forty-five patients with schizophrenia and related psychoses admitted to a psychiatric hospital and 67 relatives were included. Assessments included FEERS, CFI and Positive and Negative Syndrome Scale (PANSS). Results: FEERS-Cri test-retest intra-class correlation (ICC1,1) was 0.71 among patients with low total PANSS scores, low cognitive impairment (0.59) and depression (0.63). For low levels of cognitive impairment, the ICCs of the FEERS-Wo and the FEERS-Con were 0.62 and 0.83, respectively. The FEERS-Cri and FEERS- Wo correlated significantly with CFI-CC and CFI-positive comments, respectively. Among the relatives that the patient deemed “not at all critical” (low FEERS-Cri scores), 94% had low CFI-CC levels. Conclusions: The FEERS may be a brief, time-saving alternative for identifying relatives with low levels of criticism. However, illness severity, cognitive function and mood influence FEERS test-retest reliability and link to CFI.

• Rief, Winfried; Burton, Chris; Frostholm, Lisbeth; Henningsen, Peter; Kleinstäuber, Maria & Kop, Willem J. [Vis alle 14 forfattere av denne artikkelen] (2017). Core outcome domains for clinical trials on somatic symptom disorder, bodily distress disorder, and functional somatic syndromes: European Network on Somatic Symptom Disorders recommendations. Psychosomatic Medicine. ISSN 0033-3174. 79(9), s. 1008–1015. doi: 10.1097/PSY.0000000000000502. Fulltekst i vitenarkiv
• Kaasen, Anne; Helbig, Anne; Malt, Ulrik Fredrik; Næs, Tormod; Skari, Hans & Haugen, Guttorm (2017). Maternal psychological responses during pregnancy after ultrasonographic detection of structural fetal anomalies: A prospective longitudinal observational study. PLOS ONE. 12(3). doi: 10.1371/journal.pone.0174412. Fulltekst i vitenarkiv Vis sammendrag

  In this longitudinal prospective observational study performed at a tertiary perinatal referral centre, we aimed to assess maternal distress in pregnancy in women with ultrasound findings of fetal anomaly and compare this with distress in pregnant women with normal ultrasound findings. Pregnant women with a structural fetal anomaly (n = 48) and normal ultrasound (n = 105) were included. We administered self-report questionnaires (General Health Questionnaire-28, Impact of Event Scale-22 [IES], and Edinburgh Postnatal Depression Scale) a few days following ultrasound detection of a fetal anomaly or a normal ultrasound (T1), 3 weeks post-ultrasound (T2), and at 30 (T3) and 36 weeks gestation (T4). Social dysfunction, health perception, and psychological distress (intrusion, avoidance, arousal, anxiety, and depression) were the main outcome measures. The median gestational age at T1 was 20 and 19 weeks in the group with and without fetal anomaly, respectively. In the fetal anomaly group, all psychological distress scores were highest at T1. In the group with a normal scan, distress scores were stable throughout pregnancy. At all assessments, the fetal anomaly group scored significantly higher (especially on depression-related questions) compared to the normal scan group, except on the IES Intrusion and Arousal subscales at T4, although with large individual differences. In conclusion, women with a known fetal anomaly initially had high stress scores, which gradually decreased, resembling those in women with a normal pregnancy. Psychological stress levels were stable and low during the latter half of gestation in women with a normal pregnancy.

• Bürker, Britta Susanne; Gullestad, Lars; Gude, Einar; Relbo, Anne; Grov, Ingelin & Hol, Per Kristian [Vis alle 13 forfattere av denne artikkelen] (2017). Cognitive function after heart transplantation: Comparing everolimus-based and calcineurin inhibitor-based regimens. Clinical Transplantation. ISSN 0902-0063. 31(4). doi: 10.1111/ctr.12927. Fulltekst i vitenarkiv
• Bürker, Britta Susanne; Gude, Einar; Gullestad, Lars; Grov, Ingelin; Relbo, Anne & Andreassen, Arne K. [Vis alle 12 forfattere av denne artikkelen] (2017). Cognitive function among long-term survivors of heart transplantation. Clinical Transplantation. ISSN 0902-0063. 31(12), s. 1–8. doi: 10.1111/ctr.13143. Fulltekst i vitenarkiv
• Quintana, Daniel; Elvsåshagen, Torbjørn; Zak, Nathalia; Norbom, Linn Christin Bonaventure; Pedersen, Per Øystein Heiberg & Quraishi, Sophia H. [Vis alle 12 forfattere av denne artikkelen] (2017). Diurnal Variation and twenty-four hour sleep deprivation do not alter supine heart rate variability in healthy male young adults. PLOS ONE. 12:e0170921(2), s. 1–16. doi: 10.1371/journal.pone.0170921. Fulltekst i vitenarkiv Vis sammendrag

  Heart rate variability (HRV) has become an increasingly popular index of cardiac autonomic control in the biobehavioral sciences due to its relationship with mental illness and cognitive traits. However, the intraindividual stability of HRV in response to sleep and diurnal disturbances, which are commonly reported in mental illness, and its relationship with executive function are not well understood. Here, in 40 healthy adult males we calculated high frequency HRV-an index of parasympathetic nervous system (PNS) activity-using pulse oximetry during brain imaging, and assessed attentional and executive function performance in a subsequent behavioral test session at three time points: morning, evening, and the following morning. Twenty participants were randomly selected for total sleep deprivation whereas the other 20 participants slept as normal. Sleep deprivation and morning-tonight variation did not influence high frequency HRV at either a group or individual level; however, sleep deprivation abolished the relationship between orienting attention performance and HRV. We conclude that a day of wake and a night of laboratory-induced sleep deprivation do not alter supine high frequency HRV in young healthy male adults.

• Elvsåshagen, Torbjørn; Zak, Nathalia; Norbom, Linn Christin Bonaventure; Pedersen, Per Øystein Heiberg; Quraishi, Sophia H. & Bjørnerud, Atle [Vis alle 11 forfattere av denne artikkelen] (2017). Evidence for cortical structural plasticity in humans after a day of waking and sleep deprivation. NeuroImage. ISSN 1053-8119. 156, s. 214–223. doi: 10.1016/j.neuroimage.2017.05.027. Fulltekst i vitenarkiv
• Bjørke-Bertheussen, Janette; Schøyen, Helle Kristine; Andreassen, Ole Andreas; Malt, Ulrik Fredrik; Ødegaard, Ketil Joachim & Morken, Gunnar [Vis alle 10 forfattere av denne artikkelen] (2017). Right unilateral electroconvulsive therapy does not cause more cognitive impairment than pharmacologic treatment in treatment-resistant bipolar depression: A 6-month randomized controlled trial follow-up study. Bipolar Disorders. ISSN 1398-5647. 20(6), s. 531–538. doi: 10.1111/bdi.12594. Fulltekst i vitenarkiv
• Elvsåshagen, Torbjørn; Zuzarte, Pedro; Westlye, Lars Tjelta; Bøen, Erlend; Josefsen, Dag & Boye, Birgitte [Vis alle 10 forfattere av denne artikkelen] (2016). Dentate gyrus-cornu ammonis (CA) 4 volume is decreased and associated with depressive episodes and lipid peroxidation in bipolar II disorder: Longitudinal and cross-sectional analyses. Bipolar Disorders. ISSN 1398-5647. 18(8), s. 657–668. doi: 10.1111/bdi.12457. Fulltekst i vitenarkiv
• Søyseth, Torunn Stavnes; Lund, May-Brith; Bjørtuft, Øystein; Heldal, Aasta; Søyseth, Vidar & Dew, Mary Amanda [Vis alle 8 forfattere av denne artikkelen] (2016). Psychiatric disorders and psychological distress in patients undergoing evaluation for lung transplantation: a national cohort study. General Hospital Psychiatry. ISSN 0163-8343. 42, s. 67–73. doi: 10.1016/j.genhosppsych.2016.07.001. Fulltekst i vitenarkiv
• Hibar, Derrek; Westlye, Lars Tjelta; Erp, TGM Van; Rasmussen, J; Leonardo, CD & Faskowitz, J [Vis alle 70 forfattere av denne artikkelen] (2016). Subcortical volumetric abnormalities in bipolar disorder. Molecular Psychiatry. ISSN 1359-4184. 21(12), s. 1710–1716. doi: 10.1038/mp.2015.227. Fulltekst i vitenarkiv Vis sammendrag

  Considerable uncertainty exists about the defining brain changes associated with bipolar disorder (BD). Understanding and quantifying the sources of uncertainty can help generate novel clinical hypotheses about etiology and assist in the development of biomarkers for indexing disease progression and prognosis. Here we were interested in quantifying case–control differences in intracranial volume (ICV) and each of eight subcortical brain measures: nucleus accumbens, amygdala, caudate, hippocampus, globus pallidus, putamen, thalamus, lateral ventricles. In a large study of 1710 BD patients and 2594 healthy controls, we found consistent volumetric reductions in BD patients for mean hippocampus (Cohen’s d=−0.232; P=3.50 × 10−7) and thalamus (d=−0.148; P=4.27 × 10−3) and enlarged lateral ventricles (d=−0.260; P=3.93 × 10−5) in patients. No significant effect of age at illness onset was detected. Stratifying patients based on clinical subtype (BD type I or type II) revealed that BDI patients had significantly larger lateral ventricles and smaller hippocampus and amygdala than controls. However, when comparing BDI and BDII patients directly, we did not detect any significant differences in brain volume. This likely represents similar etiology between BD subtype classifications. Exploratory analyses revealed significantly larger thalamic volumes in patients taking lithium compared with patients not taking lithium. We detected no significant differences between BDII patients and controls in the largest such comparison to date. Findings in this study should be interpreted with caution and with careful consideration of the limitations inherent to meta-analyzed neuroimaging comparisons.

• Malt, Eva; Juhasz, Katalin; Malt, Ulrik Fredrik & Naumann, Thomas (2016). A role for the transcription factor Nk2 homeobox 1 in schizophrenia: Convergent evidence from animal and human studies. Frontiers in Behavioral Neuroscience. 10. doi: 10.3389/fnbeh.2016.00059. Fulltekst i vitenarkiv Vis sammendrag

  Schizophrenia is a highly heritable disorder with diverse mental and somatic symptoms. The molecular mechanisms leading from genes to disease pathology in schizophrenia remain largely unknown. Genome-wide association studies (GWASs) have shown that common single-nucleotide polymorphisms associated with specific diseases are enriched in the recognition sequences of transcription factors that regulate physiological processes relevant to the disease. We have used a “bottom-up” approach and tracked a developmental trajectory from embryology to physiological processes and behavior and recognized that the transcription factor NK2 homeobox 1 (NKX2-1) possesses properties of particular interest for schizophrenia. NKX2-1 is selectively expressed from prenatal development to adulthood in the brain, thyroid gland, parathyroid gland, lungs, skin, and enteric ganglia, and has key functions at the interface of the brain, the endocrine-, and the immune system. In the developing brain, NKX2-1-expressing progenitor cells differentiate into distinct subclasses of forebrain GABAergic and cholinergic neurons, astrocytes, and oligodendrocytes. The transcription factor is highly expressed in mature limbic circuits related to context-dependent goal-directed patterns of behavior, social interaction and reproduction, fear responses, responses to light, and other homeostatic processes. It is essential for development and mature function of the thyroid gland and the respiratory system, and is involved in calcium metabolism and immune responses. NKX2-1 interacts with a number of genes identified as susceptibility genes for schizophrenia. We suggest that NKX2-1 may lie at the core of several dose dependent pathways that are dysregulated in schizophrenia. We correlate the symptoms seen in schizophrenia with the temporal and spatial activities of NKX2-1 in order to highlight promising future research areas.

• Dahl, Johan; Ormstad, Heidi Kristin; Aass, Hans Christian; Sandvik, Leiv; Malt, Ulrik Fredrik & Andreassen, Ole Andreas (2016). Recovery from major depressive disorder episode after non-pharmacological treatment is associated with normalized cytokine levels. Acta Psychiatrica Scandinavica. ISSN 0001-690X. 134(1), s. 40–47. doi: 10.1111/acps.12576. Fulltekst i vitenarkiv Vis sammendrag

  Background Several lines of evidence show that the immune system is implicated in the pathophysiology of major depressive disorder (MDD) and that treatment with antidepressants affects cytokine and C-reactive protein (CRP) levels. Few studies have investigated immune markers during non-pharmacological treatment. In this follow-up study, we investigated whether CRP and elevated plasma cytokine levels observed before treatment of an acute episode of MDD are normalized during non-pharmacological treatment. Methods We obtained clinical assessments and blood for CRP and cytokine analysis from 50 unmedicated MDD patients, and cytokine levels from healthy controls. The patients received ‘therapy as usual’ for 12 weeks, and the assessments were then repeated. Of the 43 completers, 29 patients did not receive medication. Results In the patients receiving treatment without antidepressants, the depressive symptoms and the plasma levels of eight cytokines (interleukin (IL)-1Ra, IL-5,-6,-8,-10, G-CSF, IFN-γ, and TNF-α) were significantly reduced (P = 0.002–0.048). The cytokine levels were no longer different from the controls. The plasma CRP level did not change. Conclusion Cytokine plasma levels normalized during recovery from an acute depressive episode in MDD without antidepressant treatment. These findings may have implications for the understanding of the role of the immune system in depression and recovery from depression.

• Elvsåshagen, Torbjørn; Norbom, Linn Christin Bonaventure; Pedersen, Per Øystein Heiberg; Quraishi, Sophia H.; Bjørnerud, Atle & Malt, Ulrik Fredrik [Vis alle 8 forfattere av denne artikkelen] (2015). Widespread changes in white matter microstructure after a day of waking and sleep deprivation. PLOS ONE. 10:e0127351(5). doi: 10.1371/journal.pone.0127351. Fulltekst i vitenarkiv Vis sammendrag

  Background Elucidating the neurobiological effects of sleep and waking remains an important goal of the neurosciences. Recently, animal studies indicated that sleep is important for cell membrane and myelin maintenance in the brain and that these structures are particularly susceptible to insufficient sleep. Here, we tested the hypothesis that a day of waking and sleep deprivation would be associated with changes in diffusion tensor imaging (DTI) indices of white matter microstructure sensitive to axonal membrane and myelin alterations. Methods Twenty-one healthy adult males underwent DTI in the morning [7:30AM; time point (TP)1], after 14 hours of waking (TP2), and then after another 9 hours of waking (TP3). Whole brain voxel-wise analysis was performed with tract based spatial statistics. Results A day of waking was associated with widespread increases in white matter fractional anisotropy, which were mainly driven by radial diffusivity reductions, and sleep deprivation was associated with widespread fractional anisotropy decreases, which were mainly explained by reductions in axial diffusivity. In addition, larger decreases in axial diffusivity after sleep deprivation were associated with greater sleepiness. All DTI changes remained significant after adjusting for hydration measures. Conclusions This is the first DTI study of sleep deprivation in humans. Although previous studies have observed localized changes in DTI indices of cerebral microstructure over the course of a few hours, further studies are needed to confirm widespread DTI changes within hours of waking and to clarify whether such changes in white matter microstructure serve as neurobiological substrates of sleepiness.

• Dahl, Johan; Andreassen, Ole Andreas; Verkerk, Robert; Malt, Ulrik Fredrik; Sandvik, Leiv & Brundin, Lena [Vis alle 7 forfattere av denne artikkelen] (2015). Ongoing episode of major depressive disorder is not associated with elevated plasma levels of kynurenine pathway markers. Psychoneuroendocrinology. ISSN 0306-4530. 56, s. 12–22. doi: 10.1016/j.psyneuen.2015.02.011. Fulltekst i vitenarkiv Vis sammendrag

  Background It has been suggested that the development of depressive symptoms as a result of cytokine therapy is attributable to cytokine-induced elevated activity of the kynurenine pathway. The few studies of this mechanism in patients with common major depressive disorder (MDD) have yielded inconsistent results. The aim of the present study was to identify markers of the kynurenine pathway in a clinical MDD sample with increased cytokine levels. Methods Fifty medication-free MDD patients with a depressive episode and 34 healthy controls were included at baseline; the patients were followed for 12 weeks. Before initiating treatment, the patients were diagnosed and assessed for depressive symptoms and their blood was analyzed for tryptophan and its metabolites in the kynurenine pathway. The clinical assessments and metabolite measurements were repeated after 12 weeks of “treatment as usual”. Results We did not find significant elevation of kynurenine plasma markers in patients with a depressive episode compared to healthy controls, despite elevated cytokine levels in the patients. Clinical depression scores were significantly reduced after 12 weeks, but no significant change in the plasma kynurenine pathway plasma markers was observed. Conclusion The obtained results do not support the hypothesis that MDD depressive episodes are associated with elevated activity in the kynurenine pathway. This suggests that the pathophysiology underlying depressive episodes in common MDD differs from that of interferon induced depression. Our results warrant further study of the interplay between the kynurenine pathway and the cytokine activation patterns in these conditions.

• Pham, Uyen Ha Gia; Solbakk, Anne-Kristin; Skogseid, Inger Marie; Toft, Mathias; Pripp, Are Hugo & Konglund, Ane [Vis alle 11 forfattere av denne artikkelen] (2015). Personality changes after deep brain stimulation in Parkinson's Disease. Parkinson's Disease. ISSN 2090-8083. 2015:490507. doi: 10.1155/2015/490507. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Andreassen, Ole; Malt, Ulrik Fredrik & Melle, Ingrid (2026). Lærebok i psykiatri | Gyldendal. Gyldendal Forlag. ISBN 9788205599277. 1172 s. Fulltekst i vitenarkiv Vis sammendrag

  Boken er den mest omfattende læreboken i psykiatri i Norge.

• Andreassen, Ole Andreas; Malt, Ulrik Fredrik; Malt, Eva Albertsen & Melle, Ingrid (2020). Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISBN 9788205526624. 519 s. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (2018). Lærebok i psykiatri. Gyldendal Akademisk. ISBN 9788205494633. 1060 s. Fulltekst i vitenarkiv

Se alle arbeider i NVA

• Reme, Silje Endresen; Landmark, Live; Asprusten, Tarjei Tørre; Suvatne, Christer; Herner, Linn Breen & Drivenes, Elin [Vis alle 63 forfattere av denne artikkelen] (2026). Gi pasientene livet tilbake. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 146. doi: 10.4045/tidsskr.26.0480. Fulltekst i vitenarkiv Vis sammendrag

  Vi vet nok til å kunne hjelpe langt flere pasienter med langvarige symptomer. Likevel holder vi tilbake håpet, av frykt for å skuffe. Det kan koste pasientene store deler av livet. Denne kronikken er et faglig opprop fra 63 klinikere, forskere og fagpersoner fra hele landet. Vi har klinisk og forskningsmessig erfaring med vedvarende fysiske symptomer, som smerter, utmattelse, «hjernetåke», svimmelhet og mageplager og har samlet oss om et felles budskap: Ny kunnskap om hvordan slike symptomer oppstår og opprettholdes gir grunn til langt større håp om bedring enn mange pasienter får formidlet i dag.

• Malt, Ulrik Fredrik; Halvorsen, Joar Øveraas; Smeland, Olav Bjerkehagen & Høglend, Per Andreas (2026). Kunnskapsbasert psykiatri. doi: https:/www.gyldendal.no/faglitteratur/medisin/laereboeker/laerebok-i-psykiatri/p-10038591. Fulltekst i vitenarkiv
• Helsingen, Lise Mørkved; Langeland, Eline Aurvoll; Pisani, Synne Eline Rotihaug; Vandvik, Per Olav; Haavardsholm, Espen A. & Malt, Ulrik Fredrik [Vis alle 10 forfattere av denne artikkelen] (2024). Glansbilder av nasjonale faglige retningslinjer fra Helsedirektoratet. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 144(5). doi: 10.4045/tidsskr.24.0141. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2022). Håndtering av seponeringsproblemer krever høy faglighet. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142(15). doi: 10.4045/tidsskr.22.0628. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2020). Misleading conclusion about melancholic features and prediction of long-term mortality. Journal of Psychosomatic Research. ISSN 0022-3999. 135. doi: 10.1016/j.jpsychores.2020.110139. Fulltekst i vitenarkiv
• Bramness, Jørgen Gustav & Malt, Ulrik Fredrik (2020). Nedtrapping av antipsykotiske legemidler. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 140(10), s. 1–2. doi: 10.4045/tidsskr.20.0322. Fulltekst i vitenarkiv Vis sammendrag

  Nypubliserte kliniske råd om nedtrapping og seponering av antipsykotiske legemidler kan bidra med god kunnskap for bedre praksis i et evidenssvakt felt.

• Malt, Eva Albertsen; Halmøy, Anne; Nærland, Terje & Malt, Ulrik Fredrik (2020). Nevroutviklingsforsatyrrelser, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 149–168. Fulltekst i vitenarkiv
• Boye, Birgitte; Malt, Eva Albertsen & Malt, Ulrik Fredrik (2020). Psykosomatiske lidelser, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 263–292. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik; Bürker, Britta Susanne & Malt, Eva Albertsen (2020). Konsultasjon-liaison-psykiatri, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 385–416. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik & Malt, Eva Albertsen (2020). Den psykiatriske undersøkelsen, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 35–68. Fulltekst i vitenarkiv
• Høye, Anne; Malt, Ulrik Fredrik & Malt, Eva Albertsen (2020). Angstlidelser, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 105–135. Fulltekst i vitenarkiv
• Johnsen, Erik; Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Årsland, Dag & Malt, Eva Albertsen (2020). Psykofarmakologisk behandling av psykiske lidelser, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 467–502. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik & Malt, Eva Albertsen (2020). Obsessiv-kompulsiv lidelse, Lærebok i psykiatri Basisversjon. Gyldendal Norsk Forlag A/S. ISSN 9788205526624. s. 137–148. Fulltekst i vitenarkiv
• Kaufmann, Tobias; Meer, Dennis van der; Doan, Nhat Trung; Schwarz, Emanuel; Lund, Martina Jonette & Agartz, Ingrid [Vis alle 97 forfattere av denne artikkelen] (2020). Publisher Correction: Common brain disorders are associated with heritable patterns of apparent aging of the brain (Nature Neuroscience, (2019), 22, 10, (1617-1623), 10.1038/s41593-019-0471-7). Nature Neuroscience. ISSN 1097-6256. 23(2), s. 295–295. doi: 10.1038/s41593-019-0553-6. Fulltekst i vitenarkiv
• Bramness, Jørgen Gustav & Malt, Ulrik Fredrik (2020). Nedtrapping av antipsykotiske legemidler. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidsskr.20.0322. Fulltekst i vitenarkiv
• Aarsland, Dag; Selbæk, Geir & Malt, Ulrik Fredrik (2018). Alderspsykiatri. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 707–740. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik & Malt, Eva Albertsen (2018). Angstlidelser. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 265–320. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik & Malt, Eva Albertsen (2018). Den psykiatriske undersøkelsen. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 143–176. Fulltekst i vitenarkiv
• Andreassen, Ole Andreas; Malt, Eva Albertsen; Malt, Ulrik Fredrik; Aarsland, Dag & Melle, Ingrid (2018). Biopsykososial forståelsesmodell. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 135–142. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik & Malt, Eva Albertsen (2018). Obsessiv-kompulsiv lidelse. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 321–346. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik; Bürker, Britta Susanne & Malt, Eva Albertsen (2018). Konsultasjon-liaison psykliatri. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 765–828. Fulltekst i vitenarkiv
• Malt, Eva Albertsen; Linaker, Olav Morten; Nærland, Terje & Malt, Ulrik Fredrik (2018). Autismespekterlidelser og psykisk utviklingshemming. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 675–706. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik & Malt, Eva Albertsen (2018). Strukturerte psykologiske og andre ikke-biologiske behandlingsmetoder. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 865–888. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Johnsen, Erik; Aarsland, Dag & Malt, Eva Albertsen (2018). Psykofarmakologisk behandling av psykiske lidelser. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 897–976. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik; Boye, Birgitte & Malt, Eva Albertsen (2018). Psykosomatiske lidelser. I Malt, Ulrik Fredrik; Andreassen, Ole Andreas; Malt, Eva Albertsen; Melle, Ingrid & Aarsland, Dag (Red.), Lærebok i psykiatri. Gyldendal Akademisk. ISSN 9788205494633. s. 521–570. Fulltekst i vitenarkiv
• Skreden, Marianne; Björk, Merethe Dalholt; Emblem, Ragnhild; Skari, Hans; Pripp, Are Hugo & Faugli, Anne [Vis alle 8 forfattere av denne artikkelen] (2018). Parental mental health problems from second trimester to the early postpartum period: a prospective cohort study. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Tvangsmedisinering og tvangsmiddelbruk ved psykoser :. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(14/15), s. 982–983. doi: 10.4045/tidsskr.17.0675. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Tankekjør - en betegnelse som er kommet for å bli :. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(20), s. 1576–1577. doi: 10.4045/tidsskr.17.0871. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Re: Psykiatriens indre konflikter eksponert. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(9), s. 594–594. doi: 10.4045/tidsskr.17.0287. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Re: Tvangsmedisinering må forbys. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(9), s. 601–602. doi: 10.4045/tidsskr.17.0302. Fulltekst i vitenarkiv
• Kaasen, Anne; Helbig, Anne; Malt, Ulrik Fredrik; Skari, Hans; Næs, Tormod & Haugen, Guttorm (2017). Parental psychological stress responses in pregnancy after ultrasonographic detection of fetal malformation. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Re: Fjerndiagnostisering. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(7/8), s. 508–509. doi: 10.4045/tidsskr.17.0232. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Debatten om SSRI bør omhandle hvem som har utbytte av disse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(11), s. 781–782. doi: 10.4045/tidsskr.17.0448. Fulltekst i vitenarkiv
• Malt, Ulrik Fredrik (2017). Debatten om SSRI-midlene bør omhandle hvem som har utbytte av disse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 137(12/13), s. 855–856. doi: 10.4045/tidsskr.17.0471. Fulltekst i vitenarkiv
• Søyseth, Torunn Stavnes; Lund, MB; Haugstad, Gro Killi; Bjørtuft, Øystein; Søyseth, Vidar & Malt, Ulrik Fredrik (2016). Significant Associations between emotional coping strategies and psychological distress- a national cohort study of potential lung transplant candidates. Fulltekst i vitenarkiv
• Helbig, Anne; Kaasen, Anne; Malt, Ulrik Fredrik & Haugen, Guttorm (2016). Does maternal psychological distress in third trimester affect fetal cerebro-placental circulation measures? Fulltekst i vitenarkiv
• Helbig, Anne; Kaasen, Anne; Malt, Ulrik Fredrik & Haugen, Guttorm (2016). Does early antenatal maternal psychological distress affect fetal cerebro-placental circulation in third trimester? Fulltekst i vitenarkiv
• Søyseth, Torunn Stavnes; Haugstad, Gro Killi; Bjørtuft, Øystein; Lund, May Brit; Søyseth, Vidar & Malt, Ulrik Fredrik (2015). Psychological distress in Potential Lung Tranplant Candidates: A National Cohort Study. Fulltekst i vitenarkiv
• Løvdahl, Hans; Bøen, Erlend; Malt, Eva & Malt, Ulrik Fredrik (2015). Erratum to "Somatic and cognitive symptoms as indicators of potential endophenotypes in bipolar spectrum disorders: An exploratory and proof-of-concept study comparing bipolar II disorder with recurrent brief depression and healthy controls" [Journal of Affective Disorders 166 (2014) (59-70)]. Journal of Affective Disorders. ISSN 0165-0327. 175, s. 217–217. doi: 10.1016/j.jad.2014.10.011. Fulltekst i vitenarkiv
• Schøyen, Helle Kristine; Kessler, Ute; Andreassen, Ole Andreas; Auestad, Bjørn Henrik; Bergsholm, Per & Malt, Ulrik Fredrik [Vis alle 9 forfattere av denne artikkelen] (2015). Response to Kotzalidis et al. American Journal of Psychiatry. ISSN 0002-953X. doi: 10.1176/appi.ajp.2014.14101366r. Fulltekst i vitenarkiv
• Schøyen, Helle Kristine; Kessler, Ute; Andreassen, Ole Andreas; Auestad, Bjørn Henrik; Bergsholm, Per & Malt, Ulrik Fredrik [Vis alle 9 forfattere av denne artikkelen] (2015). Response to Kellner and Fink. American Journal of Psychiatry. ISSN 0002-953X. doi: 10.1176/appi.ajp.2014.14101284r. Fulltekst i vitenarkiv

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