Young people at risk for developing bipolar disorder: Two-year findings from the multicenter prospective, naturalistic Early-BipoLife study.

Early identification and intervention of individuals with an increased risk for bipolar disorder (BD) may improve the course of illness and prevent long­term consequences. Early-BipoLife, a multicenter, prospective, naturalistic study, examined risk factors of BD beyond family history in participants aged 15-35 years. At baseline, positively screened help-seeking participants (screenBD at-risk) were recruited at Early Detection Centers and in- and outpatient depression and attention-deficit/hyperactivity disorder (ADHD) settings, references (Ref) drawn from a representative cohort. Participants reported sociodemographics and medical history and were repeatedly examined regarding psychopathology and the course of risk factors. N = 1,083 screenBD at-risk and n = 172 Ref were eligible for baseline assessment. Within the first two years, n = 31 screenBD at-risk (2.9 %) and none of Ref developed a manifest BD. The cumulative transition risk was 0.0028 at the end of multistep assessment, 0.0169 at 12 and 0.0317 at 24 months (p = 0.021). The transition rate with a BD family history was 6.0 %, 4.7 % in the Early Phase Inventory for bipolar disorders (EPIbipolar), 6.6 % in the Bipolar Prodrome Interview and Symptom Scale-Prospective (BPSS-FP) and 3.2 % with extended Bipolar At-Risk - BARS criteria). In comparison to help-seeking young patients from psychosis detection services, transition rates in screenBD at-risk participants were lower. The findings of Early-BipoLife underscore the importance of considering risk factors beyond family history in order to improved early detection and interventions to prevent/ameliorate related impairment in the course of BD. Large long-term cohort studies are crucial to understand the developmental pathways and long-term course of BD, especially in people at- risk.

Neural correlates of response inhibition and performance monitoring in binge watching.

With increasing popularity of internet streaming portals, the question why people develop excessive binge-watching behavior has become a focus of scientific research. The possible negative consequences of this behavior and its proximity to behavioral addictions are discussed. Since deficits of response inhibition and performance monitoring have been associated with substance use and addictive behaviors, we examined the hypothesis whether frequent binge watching is characterized by alterations in these processes. The current study examined response inhibition in a go/nogo task and performance monitoring in a flanker task using electroencephalography. Participants reported frequent binge-watching episodes (HBW, n = 35) or no binge-watching behavior (NBW, n = 33) during the past four weeks. Compared to the NBW group, HBW showed larger P3a and P3b during response inhibition and larger error-related negativity (ERN) for errors in the flanker task. Group differences in behavioral measures were not observed. The neurocognitive profile associated with frequent binge watching differs from externalizing disorders, such as substance use disorders and addictive behaviors, which are more likely to be associated with diminished amplitudes during response inhibition and performance monitoring. Current findings of increased activity in performance monitoring and inhibition tend to be associated with internalizing disorders. Therefore, symptoms such as anxiety and worry may play a role in the development of binge-watching behavior.