TY - JOUR
T1 - Clinical and biological correlates of resilience in patients with schizophrenia and bipolar disorder
T2 - A cross-sectional study
AU - Mizuno, Yuya
AU - Hofer, Alex
AU - Suzuki, Takefumi
AU - Frajo-Apor, Beatrice
AU - Wartelsteiner, Fabienne
AU - Kemmler, Georg
AU - Saruta, Juri
AU - Tsukinoki, Keiichi
AU - Mimura, Masaru
AU - Fleischhacker, W. Wolfgang
AU - Uchida, Hiroyuki
N1 - Funding Information:
Dr. Fleischhacker has received research grants from Otsuka Pharmaceutical, Janssen Cilag and Lundbeck. Advisory board honoraria from Lundbeck, Roche, Otsuka Pharmaceutical, Janssen Cilag, Takeda, Amgen, Teva and Targacept. Speaker honoraria from AOP Orphan, Lundbeck, Janssen Cilag, Otsuka Pharmaceutical, Roche and Takeda within the past two years and holds stock from MedAvante.
Funding Information:
This work was supported by Grant-in-Aid for Young Scientists-B from the Ministry of Education, Culture, Sports, Science and Technology (H.U., grant number 25870713 ); Astellas Foundation for Research on Metabolic Disorders (H.U.) ; SENSHIN Medical Research Foundation (H.U.) ; Keio University Grant-in-Aid for Encouragement of Young Medical Scientists (Y.M.) ; and the Inokashira Hospital Foundation (Y.M.) . These five funding sources had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.
Publisher Copyright:
© 2016 Elsevier B.V.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objective The concept of resilience is relevant in understanding the heterogeneous outcomes noted in schizophrenia and bipolar disorder. However, clinical and biological correlates of resilience in these populations have rarely been investigated. We aimed to identify key correlates of subjective resilience in such patients using comprehensive assessments and to explore associations between resilience levels and peripheral biomarkers. Method 180 subjects with DSM-IV schizophrenia, bipolar disorder, and healthy controls (60 per group) were included. Demographic and clinical variables were assessed by means of interview and various psychometric scales. Furthermore, blood and saliva samples were obtained for the assessment of brain-derived neurotrophic factor, adrenocorticotropic hormone, cortisol, high sensitivity C-reactive protein, and alpha-amylase levels. Cross-sectional associations with resilience, as assessed by the 25-item Resilience Scale were sought. Results Resilience Scale total scores were significantly higher in healthy individuals (130.1, 95% confidence intervals (CI): 124.8–135.4) compared to subjects with schizophrenia (109.9, 95% CI: 104.6–115.2, p < 0.001) and bipolar disorder (119.0, 95% CI: 113.8–124.3, p = 0.012), while the difference between patient groups was non-significant (p = 0.055). Self-esteem, spirituality, quality of life, and hopelessness were correlated with resilience in all three groups. In addition, internalized stigma and depression were relevant factors in the schizophrenia and bipolar disorder group, respectively. Correlations between resilience levels and peripheral biomarkers did not reach significance. Conclusion Although causal relationships must be confirmed in prospective studies, our results have implications in developing psychological interventions to enhance resilience in patients with schizophrenia and bipolar disorder. The biological correlates of resilience in these populations warrant further investigations.
AB - Objective The concept of resilience is relevant in understanding the heterogeneous outcomes noted in schizophrenia and bipolar disorder. However, clinical and biological correlates of resilience in these populations have rarely been investigated. We aimed to identify key correlates of subjective resilience in such patients using comprehensive assessments and to explore associations between resilience levels and peripheral biomarkers. Method 180 subjects with DSM-IV schizophrenia, bipolar disorder, and healthy controls (60 per group) were included. Demographic and clinical variables were assessed by means of interview and various psychometric scales. Furthermore, blood and saliva samples were obtained for the assessment of brain-derived neurotrophic factor, adrenocorticotropic hormone, cortisol, high sensitivity C-reactive protein, and alpha-amylase levels. Cross-sectional associations with resilience, as assessed by the 25-item Resilience Scale were sought. Results Resilience Scale total scores were significantly higher in healthy individuals (130.1, 95% confidence intervals (CI): 124.8–135.4) compared to subjects with schizophrenia (109.9, 95% CI: 104.6–115.2, p < 0.001) and bipolar disorder (119.0, 95% CI: 113.8–124.3, p = 0.012), while the difference between patient groups was non-significant (p = 0.055). Self-esteem, spirituality, quality of life, and hopelessness were correlated with resilience in all three groups. In addition, internalized stigma and depression were relevant factors in the schizophrenia and bipolar disorder group, respectively. Correlations between resilience levels and peripheral biomarkers did not reach significance. Conclusion Although causal relationships must be confirmed in prospective studies, our results have implications in developing psychological interventions to enhance resilience in patients with schizophrenia and bipolar disorder. The biological correlates of resilience in these populations warrant further investigations.
KW - Biomarkers
KW - Bipolar disorder
KW - Recovery
KW - Resilience
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=84966714449&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84966714449&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2016.04.047
DO - 10.1016/j.schres.2016.04.047
M3 - Article
C2 - 27185483
AN - SCOPUS:84966714449
SN - 0920-9964
VL - 175
SP - 148
EP - 153
JO - Schizophrenia Research
JF - Schizophrenia Research
IS - 1-3
ER -
