@article{LeopoldBauerBechdolfetal.2020,
  author    = {Leopold, Karolina and Bauer, Michael and Bechdolf, Andreas and Correll, Christoph U. and Holtmann, Martin and Juckel, Georg and Lambert, Martin and Meyer, Thomas D. and Pfeiffer, Steffi and Kittel-Schneider, Sarah and Reif, Andreas and Stamm, Thomas J. and Rottmann-Wolf, Maren and Mathiebe, Josephine and Kellmann, Eva L. and Ritter, Philipp and Kr{\"u}ger-{\"O}zg{\"u}rdal, Seza and Karow, Anne and Sondergeld, Lene-Marie and Roessner, Veit and Sauer, Cathrin and Pfennig, Andrea},
  title     = {Efficacy of cognitive-behavioral group therapy in patients at risk for serious mental illness presenting with subthreshold bipolar symptoms: Results from a prespecified interim analysis of a multicenter, randomized, controlled study},
  series = {Bipolar Disorders},
  volume    = {22},
  journal   = {Bipolar Disorders},
  number    = {5},
  doi       = {10.1111/bdi.12894},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215469},
  pages     = {517 -- 529},
  year      = {2020},
  abstract  = {Objective Most patients with bipolar disorders (BD) exhibit prodromal symptoms before a first (hypo)manic episode. Patients with clinically significant symptoms fulfilling at-risk criteria for serious mental illness (SMI) require effective and safe treatment. Cognitive-behavioral psychotherapy (CBT) has shown promising results in early stages of BD and in patients at high risk for psychosis. We aimed to investigate whether group CBT can improve symptoms and functional deficits in young patients at risk for SMI presenting with subthreshold bipolar symptoms. Method In a multicenter, randomized, controlled trial, patients at clinical risk for SMI presenting with subthreshold bipolar symptoms aged 15-30 years were randomized to 14 weeks of at-risk for BD-specific group CBT or unstructured group meetings. Primary efficacy endpoints were differences in affective symptomatology and psychosocial functioning at 14 weeks. At-risk status was defined as a combination of subthreshold bipolar symptomatology, reduction of psychosocial functioning and a family history for (schizo)affective disorders. A prespecified interim analysis was conducted at 75\% of the targeted sample. Results Of 128 screened participants, 75 were randomized to group CBT (n = 38, completers = 65.8\%) vs unstructured group meetings (n = 37, completers = 78.4\%). Affective symptomatology and psychosocial functioning improved significantly at week 14 (P < .001) and during 6 months (P < .001) in both groups, without significant between-group differences. Findings are limited by the interim character of the analysis, the use of not fully validated early detection interviews, a newly adapted intervention manual, and the substantial drop-outs. Conclusions Results suggest that young patients at-risk for SMI presenting with subthreshold bipolar symptoms benefit from early group sessions. The degree of specificity and psychotherapeutic interaction needed requires clarification.},
  language  = {en}
}
@article{BiereKranzMaturaetal.2020,
  author    = {Biere, Silvia and Kranz, Thorsten M. and Matura, Silke and Petrova, Kristiyana and Streit, Fabian and Chiocchetti, Andreas G. and Grimm, Oliver and Brum, Murielle and Brunkhorst-Kanaan, Natalie and Oertel, Viola and Malyshau, Aliaksandr and Pfennig, Andrea and Bauer, Michael and Schulze, Thomas G. and Kittel-Schneider, Sarah and Reif, Andreas},
  title     = {Risk Stratification for Bipolar Disorder Using Polygenic Risk Scores Among Young High-Risk Adults},
  series = {Frontiers in Psychiatry},
  volume    = {11},
  journal   = {Frontiers in Psychiatry},
  doi       = {10.3389/fpsyt.2020.552532},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214976},
  year      = {2020},
  abstract  = {Objective: Identifying high-risk groups with an increased genetic liability for bipolar disorder (BD) will provide insights into the etiology of BD and contribute to early detection of BD. We used the BD polygenic risk score (PRS) derived from BD genome-wide association studies (GWAS) to explore how such genetic risk manifests in young, high-risk adults. We postulated that BD-PRS would be associated with risk factors for BD. Methods: A final sample of 185 young, high-risk German adults (aged 18-35 years) were grouped into three risk groups and compared to a healthy control group (n = 1,100). The risk groups comprised 117 cases with attention deficit hyperactivity disorder (ADHD), 45 with major depressive disorder (MDD), and 23 help-seeking adults with early recognition symptoms [ER: positive family history for BD, (sub)threshold affective symptomatology and/or mood swings, sleeping disorder]. BD-PRS was computed for each participant. Logistic regression models (controlling for sex, age, and the first five ancestry principal components) were used to assess associations of BD-PRS and the high-risk phenotypes. Results: We observed an association between BD-PRS and combined risk group status (OR = 1.48, p < 0.001), ADHD diagnosis (OR = 1.32, p = 0.009), MDD diagnosis (OR = 1.96, p < 0.001), and ER group status (OR = 1.7, p = 0.025; not significant after correction for multiple testing) compared to healthy controls. Conclusions: In the present study, increased genetic risk for BD was a significant predictor for MDD and ADHD status, but not for ER. These findings support an underlying shared risk for both MDD and BD as well as ADHD and BD. Improving our understanding of the underlying genetic architecture of these phenotypes may aid in early identification and risk stratification.},
  language  = {en}
}