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210. Is Chronotype an Endophenotype for Bipolar Disorder?
Biological Psychiatry
Thursday Abstracts
Supported By: NIMH MH019112, MH089983 Keywords: Neurocognition, Penn computerized neurocognitive battery, Parental Age, neurodevelopmental disorders
210. Is Chronotype an Endophenotype for Bipolar Disorder? Lara Baez, Lihong Cui, and Kathleen Merikangas National Institute of Mental Health, National Institutes of Health Background: Evaluation of clinical samples suggests that chronotype, which represents the extent to which a person’s mental and physical peak occurs during the morning/evening hours, may differ among people with Bipolar Disorder (BPD). The aim of this paper is to examine the association and familial aggregation and co-aggregation between chronotype with specific mood disorder subtypes in a community based family study. Methods: 387 probands and a subset of 459 of their first degree relatives with direct clinical evaluations in the NIMH Family Study of Affective Spectrum Disorders reported on chronotype assessed by the Composite Score of Morningness (CSM; high score indicates high morningness). Diagnoses of mood disorder subtypes including Bipolar I (BPI), Bipolar II (BPII), and Major Depressive Disorder (MDD) were based on best estimates of diagnostic interviews and family history report. Mixed effect regression models adjusted for age and sex were employed. Results: Probands with BPI and BPII, but not MDD, had significantly lower CSM scores than those with no disorder (p50.0092, p50.004). There was a significant association between proband and relative CSM (p50.0454). Heritability of CSM was 0.2834 (p,0.0001). CSM was elevated among relatives of probands with BPI disorder (p50.05). Conclusions: Our findings suggesting that evening chronotype is more common among those with BPD confirms growing evidence that BPD is a disturbance of circadian rhythm. The familial links between evening chronotype with BPI further indicate that chronotype may be an endophenotype that warrants further investigation, which may have implications for its etiology and pathogenesis. Supported By: NIMH IRP Keywords: Bipolar Disorder, Mood disorders, Circadian Rhythms, Endophenotype
211. Familial Patterns and Sex Differences in Comorbidity between Atypical Depression and Cardiovascular Disease and Risk Factors Jennifer Glaus1, Lihong Cui2, Martin Preisig3, and Kathleen Merikangas2 National Institutes of Health (NIH), 2National Institute of Mental Health, 3Lausanne University Hospital
1
Background: Although there is abundant evidence from clinical and community surveys regarding comorbidity of mood disorders and cardiovascular risk factors (CVRFs) and disorders (DX), the mechanisms underlying this association are complex. The objective of this paper is to investigate the
alternative mechanisms for comorbidity using a community based family study of mood spectrum disorders. Methods: The sample consisted of 273 adult probands and 505 relatives who were interviewed and participated in clinical evaluations at the NIH Clinical Center. Psychiatric assessment was based on structured diagnostic interviews and CVRFs/DX were based on self-report and clinical and laboratory examinations. Results: The results of mixed regression models that controlled for age and sex revealed that there were familial associations between atypical depression in probands and relatives (OR51.75, 1.2-3.0) and all of the CVRFs. Further, relatives of probands with atypical depression were at increased risk of overweight and physical inactivity (OR52.98, 1.0-8.6; OR52.32, 0.2-1.0, respectively). Conversely, probands with overweight were at increased risk of atypical depression (OR51.92, 1.23.2). Although there were sex differences in the base rates of CVRF/DX and atypical depression, there were no sex differences in the familial patterns of comorbidity of these conditions. Conclusions: These results suggest that there may be common familial underlying risk factors that lead to atypical depression, overweight and physical inactivity. Independent transmission of the other CVRF/DX and mood disorder subtypes suggests that comorbidity of these conditions can be attributed to causal mechanisms within individuals. These findings have important implications for both treatment and future etiologic studies. Supported By: NIMH, Swiss National Science Foundation Keywords: Cardiovascular Disease, Mood disorders, Atypical Depression, Family study, Overweight
212. Suicidal Ideation and Behavior in Institutions of Higher Learning: Categorizing Levels of Risk Joel Bernanke1, Hanga Galfalvy2, Maggie Mortali3, Laura Hoffman3, Ann Haas3, Christine Moutier3, Charles Nemeroff4, Barbara Stanley2, Paula Clayton5, Jill Harkavy-Friedman3, and Maria Oquendo2 1
Columbia University/New York State Psychiatric Institute, Columbia University, 3American Foundation for Suicide Prevention, 4University of Miami Health System, 5 University New Mexico 2
Background: Suicide is the second leading cause of death for college students, with an annual rate of 7.5 per 100,000. The American Foundation for Suicide Prevention (AFSP) developed the Interactive Screening Program (ISP) to support institutions of higher education in engaging students in mental healthcare. Methods: We used Latent Class Analysis (LCA) to identify subgroups of at-risk students from survey data collected through the ISP. LCA was applied to undergraduate student data and an appropriate latent class model was selected. The model was validated on data collected from graduate students. Results: LCA identified 6 subgroups from the undergraduate sample (N 5 5654), which we categorized from low to high acute suicide risk by the proportion of members reporting recent thoughts of suicide. The highest risk group (N 5 623, 11%) was mostly women (79%), with 66% having recent
Biological Psychiatry May 15, 2017; 81:S1–S139 www.sobp.org/journal
S87
Thursday Abstracts
Supported By: NIMH MH019112, MH089983 Keywords: Neurocognition, Penn computerized neurocognitive battery, Parental Age, neurodevelopmental disorders
210. Is Chronotype an Endophenotype for Bipolar Disorder? Lara Baez, Lihong Cui, and Kathleen Merikangas National Institute of Mental Health, National Institutes of Health Background: Evaluation of clinical samples suggests that chronotype, which represents the extent to which a person’s mental and physical peak occurs during the morning/evening hours, may differ among people with Bipolar Disorder (BPD). The aim of this paper is to examine the association and familial aggregation and co-aggregation between chronotype with specific mood disorder subtypes in a community based family study. Methods: 387 probands and a subset of 459 of their first degree relatives with direct clinical evaluations in the NIMH Family Study of Affective Spectrum Disorders reported on chronotype assessed by the Composite Score of Morningness (CSM; high score indicates high morningness). Diagnoses of mood disorder subtypes including Bipolar I (BPI), Bipolar II (BPII), and Major Depressive Disorder (MDD) were based on best estimates of diagnostic interviews and family history report. Mixed effect regression models adjusted for age and sex were employed. Results: Probands with BPI and BPII, but not MDD, had significantly lower CSM scores than those with no disorder (p50.0092, p50.004). There was a significant association between proband and relative CSM (p50.0454). Heritability of CSM was 0.2834 (p,0.0001). CSM was elevated among relatives of probands with BPI disorder (p50.05). Conclusions: Our findings suggesting that evening chronotype is more common among those with BPD confirms growing evidence that BPD is a disturbance of circadian rhythm. The familial links between evening chronotype with BPI further indicate that chronotype may be an endophenotype that warrants further investigation, which may have implications for its etiology and pathogenesis. Supported By: NIMH IRP Keywords: Bipolar Disorder, Mood disorders, Circadian Rhythms, Endophenotype
211. Familial Patterns and Sex Differences in Comorbidity between Atypical Depression and Cardiovascular Disease and Risk Factors Jennifer Glaus1, Lihong Cui2, Martin Preisig3, and Kathleen Merikangas2 National Institutes of Health (NIH), 2National Institute of Mental Health, 3Lausanne University Hospital
1
Background: Although there is abundant evidence from clinical and community surveys regarding comorbidity of mood disorders and cardiovascular risk factors (CVRFs) and disorders (DX), the mechanisms underlying this association are complex. The objective of this paper is to investigate the
alternative mechanisms for comorbidity using a community based family study of mood spectrum disorders. Methods: The sample consisted of 273 adult probands and 505 relatives who were interviewed and participated in clinical evaluations at the NIH Clinical Center. Psychiatric assessment was based on structured diagnostic interviews and CVRFs/DX were based on self-report and clinical and laboratory examinations. Results: The results of mixed regression models that controlled for age and sex revealed that there were familial associations between atypical depression in probands and relatives (OR51.75, 1.2-3.0) and all of the CVRFs. Further, relatives of probands with atypical depression were at increased risk of overweight and physical inactivity (OR52.98, 1.0-8.6; OR52.32, 0.2-1.0, respectively). Conversely, probands with overweight were at increased risk of atypical depression (OR51.92, 1.23.2). Although there were sex differences in the base rates of CVRF/DX and atypical depression, there were no sex differences in the familial patterns of comorbidity of these conditions. Conclusions: These results suggest that there may be common familial underlying risk factors that lead to atypical depression, overweight and physical inactivity. Independent transmission of the other CVRF/DX and mood disorder subtypes suggests that comorbidity of these conditions can be attributed to causal mechanisms within individuals. These findings have important implications for both treatment and future etiologic studies. Supported By: NIMH, Swiss National Science Foundation Keywords: Cardiovascular Disease, Mood disorders, Atypical Depression, Family study, Overweight
212. Suicidal Ideation and Behavior in Institutions of Higher Learning: Categorizing Levels of Risk Joel Bernanke1, Hanga Galfalvy2, Maggie Mortali3, Laura Hoffman3, Ann Haas3, Christine Moutier3, Charles Nemeroff4, Barbara Stanley2, Paula Clayton5, Jill Harkavy-Friedman3, and Maria Oquendo2 1
Columbia University/New York State Psychiatric Institute, Columbia University, 3American Foundation for Suicide Prevention, 4University of Miami Health System, 5 University New Mexico 2
Background: Suicide is the second leading cause of death for college students, with an annual rate of 7.5 per 100,000. The American Foundation for Suicide Prevention (AFSP) developed the Interactive Screening Program (ISP) to support institutions of higher education in engaging students in mental healthcare. Methods: We used Latent Class Analysis (LCA) to identify subgroups of at-risk students from survey data collected through the ISP. LCA was applied to undergraduate student data and an appropriate latent class model was selected. The model was validated on data collected from graduate students. Results: LCA identified 6 subgroups from the undergraduate sample (N 5 5654), which we categorized from low to high acute suicide risk by the proportion of members reporting recent thoughts of suicide. The highest risk group (N 5 623, 11%) was mostly women (79%), with 66% having recent
Biological Psychiatry May 15, 2017; 81:S1–S139 www.sobp.org/journal
S87