This revised Mentored Patient-Oriented Research Career Development Award (K23) application requests funding to support the training and research activities for Dr. Jess G. Fiedorowicz. His goal is to develop expertise in human cardiovascular physiology for the assessment of vascular function in patients with bipolar disorder. Vascular function represents an important intermediate phenotype in the development of atherosclerosis and has been demonstrated to be an independent predictor of cardiovascular disease. Bipolar disorders are associated with increased cardiovascular morbidity and mortality. The first-line, second- generation antipsychotics associated with weight gain (SGAWGs: risperidone, olanzapine, and quetiapine) have been associated with significant metabolic complications, which may increase risk for vascular disease. Assessment of vascular function may allow identification of clinically relevant mechanisms for the development of cardiovascular disease in patients with bipolar disorder. This research and training plan strongly emphasizes interdisciplinary and translational research as outlined by the NIH Roadmap. As a psychiatrist, Dr. Fiedorowicz seeks additional training in translational research applications in human vascular physiology and pharmacology, related statistical methodologies, and the ethical conduct and design of research. The research plan proposes a 26-week, prospective, naturalistic cohort study to examine the relationship of SGAWG use and vascular function in bipolar disorders by studying incident users of SGAWGs and non-users of antipsychotics with bipolar disorders. The primary aim of this study is to determine the magnitude and timeline of antipsychotic-induced changes in vascular function in incident users of SGAWGs. The methodology employed will allow for mechanistic investigation with particular focus on insulin resistance and visceral obesity. This application will provide a foundation for Dr. Fiedorowicz'long-term scientific goal of creating an independent program of interdisciplinary research addressing cardiovascular disease in bipolar disorders and the adverse cardiovascular effects of psychotropic medications.
Individuals with bipolar disorder bear an excess risk of death from cardiovascular disease. Some medications used to treat bipolar disorder may worsen risk factors for cardiovascular disease. This research addresses the NIMH goals of developing safer treatments and eliminating the health disparities associated with mental illness, namely the cardiovascular burden.
|Fiedorowicz, Jess G; Linder, Jonathan; Sodhi, Simrit K (2014) The search for mediators of vascular mortality with mania. Rev Bras Psiquiatr 36:98-9|
|Persons, Jane E; Robinson, Jennifer G; Ammann, Eric M et al. (2014) Omega-3 fatty acid biomarkers and subsequent depressive symptoms. Int J Geriatr Psychiatry 29:747-57|
|Cobb, Bryan S; Coryell, William H; Cavanaugh, Joseph et al. (2014) Seasonal variation of depressive symptoms in unipolar major depressive disorder. Compr Psychiatry 55:1891-9|
|Fiedorowicz, Jess G; Jancic, Dubravka; Potash, James B et al. (2014) Vascular mortality in participants of a bipolar genomics study. Psychosomatics 55:485-90|
|Fiedorowicz, Jess G (2014) Depression and cardiovascular disease: an update on how course of illness may influence risk. Curr Psychiatry Rep 16:492|
|Linder, Jonathan R; Sodhi, Simrit K; Haynes, William G et al. (2014) Effects of antipsychotic drugs on cardiovascular variability in participants with bipolar disorder. Hum Psychopharmacol 29:145-51|
|Akhter, Ahmed; Fiedorowicz, Jess G; Zhang, Tao et al. (2013) Seasonal variation of manic and depressive symptoms in bipolar disorder. Bipolar Disord :|
|Murray, Dylan P; Metz, Nora S; Haynes, William G et al. (2012) Vascular function is not impaired early in the course of bipolar disorder. J Psychosom Res 72:195-8|
|Prabhakar, Maithri; Haynes, William G; Coryell, William H et al. (2011) Factors associated with the prescribing of olanzapine, quetiapine, and risperidone in patients with bipolar and related affective disorders. Pharmacotherapy 31:806-12|
|Weiner, Miriam; Warren, Lois; Fiedorowicz, Jess G (2011) Cardiovascular morbidity and mortality in bipolar disorder. Ann Clin Psychiatry 23:40-7|
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