TY  - JOUR
A1  - Leopold, Karolina
A1  - Bauer, Michael
A1  - Bechdolf, Andreas
A1  - Correll, Christoph U.
A1  - Holtmann, Martin
A1  - Juckel, Georg
A1  - Lambert, Martin
A1  - Meyer, Thomas D.
A1  - Pfeiffer, Steffi
A1  - Kittel‐Schneider, Sarah
A1  - Reif, Andreas
A1  - Stamm, Thomas J.
A1  - Rottmann‐Wolf, Maren
A1  - Mathiebe, Josephine
A1  - Kellmann, Eva L.
A1  - Ritter, Philipp
A1  - Krüger‐Özgürdal, Seza
A1  - Karow, Anne
A1  - Sondergeld, Lene‐Marie
A1  - Roessner, Veit
A1  - Sauer, Cathrin
A1  - Pfennig, Andrea
T1  - 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
JF  - Bipolar Disorders
N2  - 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.
KW  - at‐risk
KW  - bipolar disorder
KW  - CBT
KW  - early intervention
KW  - group treatment
KW  - prodromal
KW  - serious mental illness
KW  - subthreshold bipolar
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-215469
VL  - 22
IS  - 5
SP  - 517
EP  - 529
ER  - 
TY  - JOUR
A1  - Biere, Silvia
A1  - Kranz, Thorsten M.
A1  - Matura, Silke
A1  - Petrova, Kristiyana
A1  - Streit, Fabian
A1  - Chiocchetti, Andreas G.
A1  - Grimm, Oliver
A1  - Brum, Murielle
A1  - Brunkhorst-Kanaan, Natalie
A1  - Oertel, Viola
A1  - Malyshau, Aliaksandr
A1  - Pfennig, Andrea
A1  - Bauer, Michael
A1  - Schulze, Thomas G.
A1  - Kittel-Schneider, Sarah
A1  - Reif, Andreas
T1  - Risk Stratification for Bipolar Disorder Using Polygenic Risk Scores Among Young High-Risk Adults
JF  - Frontiers in Psychiatry
N2  - 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.
KW  - polygenic risk score
KW  - bipolar disorder
KW  - genetic phenotypes
KW  - depression
KW  - ADHD
KW  - early recognition
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-214976
VL  - 11
ER  -