机构：[1]Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, and Department of Neurology, Shanghai Changhai Hospital, Secondary Military Medical University, Shanghai, China[2]Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, and Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences &Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan, China[3]Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, USA[4]Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China[5]Department of Neurology, Shanghai Changhai Hospital, Secondary Military Medical University, Shanghai, China[6]Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China[7]Department of Neurology, Shanghai Changhai Hospital, Secondary Military Medical University, Shanghai, China[8]Department of Genetics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China[9]Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming, Yunnan, China[10]Department of Pharmacology and Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, China[11]Division of Mood Disorders, Shanghai Mental Health Cente
Early identification of patients with bipolar disorder during their first depressive episode is beneficial to the outcome of the disorder and treatment, but traditionally this has been a great challenge to clinicians. Recently, brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the pathophysiology of bipolar disorder and major depressive disorder (MDD), but it is not clear whether BDNF levels can be used to predict bipolar disorder among patients in their first major depressive episode.To explore whether BDNF levels can differentiate between MDD and bipolar disorder in the first depressive episode.A total of 203 patients with a first major depressive episode as well as 167 healthy controls were recruited. After 3 years of bi-annual follow-up, 164 patients with a major depressive episode completed the study, and of these, 21 were identified as having bipolar disorder and 143 patients were diagnosed as having MDD. BDNF gene expression and plasma levels at baseline were compared among the bipolar disorder, MDD and healthy control groups. Logistic regression and decision tree methods were applied to determine the best model for predicting bipolar disorder at the first depressive episode.At baseline, patients in the bipolar disorder and MDD groups showed lower BDNF mRNA levels (P<0.001 and P = 0.02 respectively) and plasma levels (P = 0.002 and P = 0.01 respectively) compared with healthy controls. Similarly, BDNF levels in the bipolar disorder group were lower than those in the MDD group. These results showed that the best model for predicting bipolar disorder during a first depressive episode was a combination of BDNF mRNA levels with plasma BDNF levels (receiver operating characteristics (ROC) = 0.80, logistic regression; ROC = 0.84, decision tree).Our findings suggest that BDNF levels may serve as a potential differential diagnostic biomarker for bipolar disorder in a patient's first depressive episode.Royal College of Psychiatrists.
基金：
National Natural Science Foundation of China (91232719,
30971047, 81000581, 81171272), National High-tech R&D Program (863 Program,
2006AA02Z430, Ministry of Science and Technology of China), the ‘‘12th Five-year Plan’’
of National Key Technologies R&D Program (2012BAI01B04, Ministry of Science and
Technology of China), National Key Clinical Disciplines at Shanghai Mental Health Center
(OMA-MH, 2011-873), Shanghai Natural Science Foundation (13ZR1460500, 10ZR1426600),Shanghai Health Bureau Project, Shanghai Changhai Hospital Foundation, and Postdoctoral
Grant of Secondary Military Medical University.
第一作者机构：[1]Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, and Department of Neurology, Shanghai Changhai Hospital, Secondary Military Medical University, Shanghai, China
共同第一作者：
通讯作者：
通讯机构：[10]Department of Pharmacology and Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, China[11]Division of Mood Disorders, Shanghai Mental Health Cente[*1]Division of Mood Disorders, Shanghai Mental Health Center, Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road Shanghai 200030, China[*2]Department of Biostaistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, China
推荐引用方式(GB/T 7714)：
Li Zezhi,Zhang Chen,Fan Jinbo,et al.Brain-derived neurotrophic factor levels and bipolar disorder in patients in their first depressive episode: 3-year prospective longitudinal study[J].BRITISH JOURNAL OF PSYCHIATRY.2014,205(1):29-35.doi:10.1192/bjp.bp.113.134064.
APA：
Li Zezhi,Zhang Chen,Fan Jinbo,Yuan Chengmei,Huang Jia...&Fang Yiru.(2014).Brain-derived neurotrophic factor levels and bipolar disorder in patients in their first depressive episode: 3-year prospective longitudinal study.BRITISH JOURNAL OF PSYCHIATRY,205,(1)
MLA：
Li Zezhi,et al."Brain-derived neurotrophic factor levels and bipolar disorder in patients in their first depressive episode: 3-year prospective longitudinal study".BRITISH JOURNAL OF PSYCHIATRY 205..1(2014):29-35
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