Seasonal and temperamental contributions in patients with bipolar disorder and metabolic syndrome
Notice bibliographique
Résumé
Dear Editor, I read with interest the article by Altinbas et al. (in this issue) suggesting that the prevalence of the metabolic syndrome in individuals with bipolar disorder is influenced by seasonality, with higher rates reported in the winter and spring months. They further opine that temperamental dimensions (e.g. depression) constitute a vulnerability factor to the seasonal influence. The article is appropriate in highlighting that their small sample size, open label design and absence of a control group, among other limitations, affect the inferences that can be drawn from their outcome. Their paper is hypothesis-generating rather than hypothesis-confirming. The authors remind us that environmental factors (e.g. seasonality) affect susceptibility to allostatic load. It is amply documented that bipolar symptoms/episodes are affected by seasonality in susceptible subsets. It could be conceptualized that metabolic syndrome (e.g. obesity) is a phenotypic manifestation of an abnormal stress response with somatic manifestations. It would be interesting to know whether individuals with metabolic syndrome seasonality are more or less likely to also experience breakthrough symptomatology. There is tremendous interest in conceptualizing bipolar disorder as progressive disorders. I would conjecture that obesity and associated metabolic abnormalities are a cause and consequence of progression in bipolarity. Indeed, this remains a testable hypothesis. My clinical impression is that individuals with bipolar disorder who exhibit susceptibility to symptomatic recurrence as a function of seasonality often present with ‘‘mixed presentations.’’ It is tempting to further speculate that obesity, which is depressogenic, may be affecting the symptomatic presentation of bipolar disorder, increasing the likelihood that these patients will present as ‘‘mixed.’’ Again, my clinical impression is that bipolar patients that I have encountered over the last decade are more often mixed than they are euphoric, and I have wondered whether, in addition to the inappropriate use of antidepressants, obesity is changing the ‘‘face’’ of bipolar disorder. I further applaud the authors for reminding us of possible temperamental contributions and giving us a ‘‘dose of reality’’ that there will be no unidimensional explanation for psychiatric disorders that is coherent, comprehensive, and explanatory.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».