S. Frangou, United States of AmericaIcahn School of Medicine at Mount Sinai Department of Psychiatry
Moderator Of 3 Sessions
Bipolar disorder is a severe mental disorder associated with high levels of personal and societal burden. Although several pharmacological and non-pharmacological interventions have been developed and are currently available in the routine the long-term treatment of bipolar patients, the rate of functional recovery is not very satisfying yet. Many unmet needs are still present in the optimal management of bipolar patients, including diagnostic, clinical and therapeutic challenges. New perspectives are emerging for improving the clinical and functional outcomes of patients suffering from bipolar disorder. In particular, it has been recently argued that the optimal management of bipolar patients requires the evaluation of patient’s personal history according to a longitudinal perspective. In this conceptual framework, the construct of predominant polarity has been proposed by Colom for describing the predominant type of affective episodes according to a lifetime perspective. The predominant polarity has several therapeutic and prognostic implications for the long-term management of bipolar patients. Furthermore, neuroimaging correlates have recently confirmed the prognostic role of predominant polarity, highlighting the relevance of such index from a clinical perspective. In this symposium, the role of neuroimaging correlates of predominant polarity will be presented. Moreover, further new perspectives in the field of research in bipolar disorder are recently focusing on the role of childhood maltreatment and expression of symptoms during childhood as relevant predictors of long-term outcome. There is the need to translate the model of early interventions to the context of affective disorders, in order to significantly improve the long-term outcome of bipolar patients.
Presenter Of 6 Presentations
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S0122 - The Relevance of Manic Symptoms in Childhood
Background: The Adolescent Brain and Cognitive Development (ABCD) study, a US population-based sample of 10 year-olds, offers a unique opportunity to examine the neural correlates of manic-like symptoms presenting in children about to enter adolescence. Methods: The study will avail of the rich dataset of over 11,000 children aged 9-10 years at enrolment using data from the baseline and 2-year follow-up assessment. The analyses aim to track the evolution of manic-like symptoms between the two follow-up waves and test their sensitivity of their association with brain correlates. Results: Data analyses are ongoing and will focus on changes in manic-like symptoms, focusing on youth with remitting, persistent and emerging symptoms and examine their associations with brain structure and resting-state functional connectivity. Conclusions: The results will inform about the early trajectory of manic-like symptoms and offer new insights into their brain-related correlates.
S0173 - Psychosocial Adversity and the Developing Brain: Findings From the ABCD Study on 11,000 US Children
Background: Childhood exposure to social risk has the potential to disrupt brain development and increase vulnerability to adverse mental health outcomes. Here, we examine the effect of adversity on brain structure and psychopathology in the Adolescent Brain and Cognitive Development (ABCD) study, a US population-based sample of 10 year-olds. Methods: Personal, caregiver, family and neighborhood characteristics were considered in 9299 unrelated children [age: mean (sd)=9.9 y (0.6); 53% males]. Hidden Markov Models were used identify clusters of participants based on their psychosocial exposure. The identified clusters were compared in terms of current psychopathology, lifetime psychiatric diagnosis, intelligence and brain structure. Results: ABCD participants clustered in to a “disadvantaged” group (N=4205) with multiple adverse exposures, and an “enriched” group (N= 5094) with limited exposure to adversity and multiple protective factors. . Compared to the enriched group, the disadvantaged group had higher levels of all types of psychopathology and lifetime psychiatric diagnoses; lower scores on fluid and crystallized intelligence; smaller subcortical volumes; thinner sensorimotor cortices and thicker cortex in frontal regions; smaller surface area in temporal regions and larger surface area in the posterior cingulate cortices (all p<0.05 following Bonferroni correction for multiple testing). Conclusions: Social adversity has significant and wide-ranging consequences for brain development and psychopathology, that shows little specificity for types of symptoms.