Bipolar disorder represents a pathology burdened by high mortality. Recent literature is moving towards the search for somatic comorbidities or pathologies associated with psychiatric disorders. The aim of this systemic review is to search for possible alterations of markers belonging to the central nervous system, immunological, cardio-metabolic and hypothalamus-pituitary-adrenal axis in bipolar, in order to try to understand if this pathology may show systemic characteristics. The systematic search took place on the EMBASE and Pubmed databases, until January 2021; a total of 33 articles were selected, 18 for the central nervous system, 7 for the immunological, 6 for the cardiometabolic and 2 for the hypothalamic-pituitary-adrenal axis. Each selected study was subjected to AMSTAR2 quality assessment, and meta-regression was also carried out using the population sample, age, percentage of women in the studies and the quality itself as covariants. The extracted parameters were then classified according to their credibility of evidence. The study did not reveal convincing scientific evidence on the possible multi-systemic nature of bipolar disorder; However, by adapting the criteria on the population sample taken into consideration by the various studies, we found suggestive evidence of association between bipolar disorder and alterations at the level of the four systems considered.
Il disturbo bipolare rappresenta una patologia gravata da un’elevata mortalità. La recente letteratura si sta indirizzando verso la ricerca di comorbilità somatiche o patologie associate a disturbi psichiatrici. Lo scopo di questa revisione sistemica è di ricercare possibili alterazioni di marcatori appartenenti al sistema nervoso centrale, immunologico, cardio-metabolico e asse ipotalamo-ipofisi-surrene nei bipolari, in modo da cercare di comprendere se questa patologia possa mostrare caratteristiche sistemiche. La ricerca sistematica si è svolta sui database EMBASE e Pubmed, fino al gennaio 2021; un totale di 33 articoli è stato selezionato, 18 per il sistema nervoso centrale, 7 per l’immunologico, 6 per il cardiometabolico e 2 per asse ipotalamo-ipofisi-surrene. Ogni studio selezionato è stato sottoposto a valutazione AMSTAR2 della qualità, ed è stata anche svolta la meta-regressione usando come covarianti il campione di popolazione, l’età, la percentuale di donne presenti negli studi e la qualità stessa. I parametri estratti sono stati poi classificati in base alla loro credibilità di evidenza. Lo studio non ha evidenziato evidenze scientifiche convincenti sulla possibile natura multi-sistemica del disturbo bipolare; adattando però i criteri sul campione della popolazione preso in considerazione dai vari studi, abbiamo riscontrato evidenze suggestive di associazione tra il disturbo bipolare e alterazioni a livello dei quattro sistemi presi in considerazione.
Is Bipolar disorder a systemic illness?
CAVELLI, MATTIA
2020/2021
Abstract
Bipolar disorder represents a pathology burdened by high mortality. Recent literature is moving towards the search for somatic comorbidities or pathologies associated with psychiatric disorders. The aim of this systemic review is to search for possible alterations of markers belonging to the central nervous system, immunological, cardio-metabolic and hypothalamus-pituitary-adrenal axis in bipolar, in order to try to understand if this pathology may show systemic characteristics. The systematic search took place on the EMBASE and Pubmed databases, until January 2021; a total of 33 articles were selected, 18 for the central nervous system, 7 for the immunological, 6 for the cardiometabolic and 2 for the hypothalamic-pituitary-adrenal axis. Each selected study was subjected to AMSTAR2 quality assessment, and meta-regression was also carried out using the population sample, age, percentage of women in the studies and the quality itself as covariants. The extracted parameters were then classified according to their credibility of evidence. The study did not reveal convincing scientific evidence on the possible multi-systemic nature of bipolar disorder; However, by adapting the criteria on the population sample taken into consideration by the various studies, we found suggestive evidence of association between bipolar disorder and alterations at the level of the four systems considered.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/13375