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BIPLONG - The Bipolar Disorder in the Longitudinal Course

Conditions
Bipolar Disorder
Registration Number
NCT05064995
Lead Sponsor
Medical University of Graz
Brief Summary

The BIPLONG (The Bipolar Disorder in the Longitudinal Course ) study is a longitudinal study on the course of bipolar disorders and comprises two sub-studies: On the one hand, BIPLONG examines the genetic foundation and change in bipolar disorder, on the other hand, metabolic changes, clinical symptoms and cognition in bipolar disorders is evaluated. A current subproject of BIPLONG is the analysis of the psychological response of the COVID-19 (Corona virus disease) pandemic. With the parameters examined in BIPLONG, it is hoped to gain better understanding of the bipolar disorder in the longitudinal course.

Detailed Description

Study Procedure:

In addition to the bipolar patients, healthy controls will also be included. The same inventories will be used for the control subjects and the same examinations or visits will be performed; bipolar-specific disease questions will not be asked in controls.

Intervention: Longitudinal study

Method:

All patients and controls undergo several assessments every six months:

Blood samples are collected with the following main parameters of interest being examined:

* Collection and analysis of DNA, establishment of permanent cell lines, determination of mRNA and gene products (proteins), proteomics, lipidomics.

* Routine parameters: Blood count, TSH, T3, T4, homocysteine, creatinine, amylase, lipase, CK, urea, uric acid, coagulation, HBA1c, glucose, lipids (triglyceryl, LDL, HDL, cholesterol, mass spectrometry), transaminases, CRP- levels, vitamin D.

* Biomarkers: oxidative stress parameters and antioxidants, neuroinflammatory markers (e.g. interleukins, tumor necrosis factor, interferons, GDNF, VEGF, etc.), neurotrophins (BDNF, NT, Trk..), insulin, IGF, adipokines, Apo-E and AAT analysis, tryptophan/kynurenine metabolites

* Intestinal hormones grehlin, glucagon-like peptides 1 and 2 (GLP-1/2) and cholecystokinin

Additionally, socio-demographic data and psychological data are collected by administering self-assessment questionnaires. Further, neurocognitive tests are administered.

The current psychological and psychiatric state of all subjects is examined by external ratings done by experts.

Anthropomethric measures are examined (waist-to-hip ratio, blood pressure, weight, height).

Additionally, MRI is conducted on all subjects (for patients every 6 months, for controls every 12 months).

Primary hypothesis:

* Gene-environment interactions are significantly contributory to bipolar affective disorder.

* There are pathologically altered neurobiological markers that play a role in the pathogenesis of bipolar disorder.

* There is an influence of anthropometric data on the course of bipolar disorder.

Statistical analysis and anticipated sample size:

Baseline data analysis will be investigated using a multi-factorial between subject design, with the variables of group (bipolar patients versus healthy controls), gender (males versus females), weight (normal weight versus overweight), etc. as independent factors, depending on the research question. As dependent variables, in addition to sociodemographic and clinical variables (number of episodes, etc.), physiological parameters (blood parameters, anthropometry and lipometer data, EEG, ECG, MRI) and psychological variables (psychological questionnaires) will be investigated. Likewise, covariates such as age or body mass index will be included as needed.

Correlation analyses (bivariate, partial) should show possible correlations between the variables. Discriminant analyses should find out which variable best separates the investigated groups (e.g. patients vs. controls). Furthermore, regression analyses (linear, multiple) will be performed to obtain additional information about the predictive value of the variables under investigation. All analyses will be computed using IBM SPSS Statistics 20.

For the "a priori analysis" of the follow-up study (T1-T5), a repeated measures design (repeated measures within factors) was adopted. The case number calculation (effect size d between .30 and .80; Cohen, 1988) for the F-test thus results in a sample size of 47 patients with a target effect size of .40 (power 95%; alpha .05; calculated with GPower 3.1). The correlation analyses at the first measurement time point (power .95, alpha .05, effect size: .35) yields 79 subjects per group (Pat. vs. controls) at all time-points.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
560
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Maslach Burnout Inventory (MBI-GS-D)at six months

Measurement of burnout symptoms; 16 items on a scale of 1-6 (ascending). The higher the score, the worse the outcome.

Anthropometric Data - weightat six months

Measurement of weight

Global Assessment Scale of Functioning (GAF)at six months

External rating of level of functioning; 1 item on a scale of 1-100 (ascending). The higher the score, the better the outcome.

STROOP Farbe-Wort-Interferenz-Test (FWIT)at six months

As an objective and reliable multidimensional performance test, the Color-Word. The Interference Test measures elementary information processing skills (selection, encoding, and decoding) in the visual-verbal functional domain. The lower the score, the better the outcome.

D2-Rat six months

To measure the subject's ability to concentrate and the speed and accuracy in distinguishing similar visual stimuli. The higher the score, the better the outcome.

"Reading the eyes of the mind" =Theory of mindat six months

measurement of the ability to detect social cues. The higher the score, the better the outcome.

CVLT- california verbal learning testat six months

The California Verbal Learning Test (CVLT) provides a brief and individualized assessment of verbal learning strategies and processes. The higher the score, the better the outcome

Trail Making Test A/B, TMT-Aat six months

Measurement of cognitive processing speed, as well as linguistic, executive, and attentional components. The lower the score, the better the outcome.

Mehrfachwahl Wortschatz Test (MWT-B)at six months

Measurement of the general intelligence level. The higher the score, the better the outcome.

Number Symbol Testat six months

Measurement of processing speed. The higher the score, the better the outcome.

Number Repeatat six months

Measurement of working memory. The higher the score, the better the outcome.

Beck Depressions Inventar II (BDI-II)at six months

Measurement of depression severity; 21 items on a scale of 0-3 (ascending). The higher the score, the worse the outcome.

World Health Organisation Quality of Life (WHOQOL Bref)at six months

Measurement of life-quality and health; 26 items on a scale of 1-5 (ascending).

Life Event Questionnaire (LEQ)at six months

Measurement of life events and their influence; 79 items on a scale of 0-3 (ascending)

Anthropometric Data - blood pressureat six months

Measurement of blood pressure

Clinical Global Impression (CGI)at six months

External rating of a symptom severity; 2 items on a scale of 0-7 (ascending). The higher the score, the better the outcome.

Manie-Selbstbeurteilungsskala (MSS) (self-rating scale)at six months

Measurement of manic symptoms; 48 items (dichotomous). The higher the score, the worse the outcome.

Questionnaire of religiosityat six months

socio-demographic assesment of religiosity; 2 items.

Big Five Inventory-10 (BFI-10)at six months

Measurement of personality variables; 10 items on a scale of 1-5 (ascending).

Temperament and affective disorders (TEMPS-A)-Scaleat six months

35 items on a scale of 1-5 (ascending). The higher the score, the better the outcome.

Brief symptom inventory (BSI)at six months

Measurement of psychological symptoms; 53 items on a scale of 0-4 (ascending). The higher the score, the worse the outcome.

Anhedonia scale (AS)at six months

Measurement of Anhedonia; 14 items on a scale of 1-4 (ascending). The higher the score, the worse the outcome.

Satisfaction in the couple relationship (ZIP)at six months

Measurement of relationship satisfaction; 7 items on a scale of 1-5 (ascending), 3 items open questioned. The higher the score, the better the outcome.

Demographic Dataat six months

Measurement of demographic data

Questionnaire of current life situationat six months

Measurement of demographic and diagnostic data;

Resources in Sexuality and Partnership (RSP)at six months

Measurement of relationship emotions; 25 items on a scale of 1-5 (ascending).The higher the score, the better the outcome.

Anthropometric Data- heightat six months

Measurement of height

Anthropometric Data - waist-to-hip ratioat six months

Measurement of waist-to-hip ratio

Hamilton Depression Scale (HAMD)at six months

External rating of depression symptoms; 21 items on a scale of 0-4 (ascending).The higher the score, the worse the outcome.

Young Mania Rating Scale (YMRS)at six months

External rating of manic symptoms; 11 items on a scale of 0-4/0-8 (ascending). The higher the score, the worse the outcome.

Specific Level of Functioning Assessment and Physical health Inventory (SLOF)at six months

External rating of functioning; 43 items on a scale of 1-5 (ascending), 2 items open questioned. The higher the score, the better the outcome.

Supplementary Data for External Ratingat six months

External rating of bipolar symptoms; 7 items.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Medical University Graz

🇦🇹

Graz, Styria, Austria

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