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.

Public Health Relevance

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.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Study Section
Cardiovascular and Sleep Epidemiology (CASE)
Program Officer
Chavez, Mark
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University of Iowa
Schools of Medicine
Iowa City
United States
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Johnson, Casey P; Christensen, Gary E; Fiedorowicz, Jess G et al. (2018) Alterations of the cerebellum and basal ganglia in bipolar disorder mood states detected by quantitative T1? mapping. Bipolar Disord 20:381-390
Tong, Brian; Abosi, Oluchi; Schmitz, Samantha et al. (2018) Bipolar disorder and related mood states are not associated with endothelial function of small arteries in adults without heart disease. Gen Hosp Psychiatry 51:36-40
Shaffer Jr, Joseph J; Johnson, Casey P; Fiedorowicz, Jess G et al. (2018) Impaired sensory processing measured by functional MRI in Bipolar disorder manic and depressed mood states. Brain Imaging Behav 12:837-847
Pierce, Gary L; Kalil, Graziela Z; Ajibewa, Tiwaloluwa et al. (2017) Anxiety independently contributes to elevated inflammation in humans with obesity. Obesity (Silver Spring) 25:286-289
Persons, Jane E; Robinson, Jennifer G; Coryell, William H et al. (2016) Longitudinal study of low serum LDL cholesterol and depressive symptom onset in postmenopause. J Clin Psychiatry 77:212-20
Fiedorowicz, Jess G; Dantz, Bezalel; Blazek, Mary C (2016) Attitudes and Confidence in the Integration of Psychiatry Scale. Acad Psychiatry 40:218-23
Connor, Cody J; Liu, Vincent; Fiedorowicz, Jess G (2015) Exploring the Physiological Link between Psoriasis and Mood Disorders. Dermatol Res Pract 2015:409637
Dindo, Lilian; Marchman, James; Gindes, Holly et al. (2015) A brief behavioral intervention targeting mental health risk factors for vascular disease: a pilot study. Psychother Psychosom 84:183-5
Fiedorowicz, Jess G; Prossin, Alan R; Johnson, Casey P et al. (2015) Peripheral inflammation during abnormal mood states in bipolar I disorder. J Affect Disord 187:172-8
Beglinger, Leigh J; Adams, William H; Fiedorowicz, Jess G et al. (2015) Practice Effects and Stability of Neuropsychological and UHDRS Tests Over Short Retest Intervals in Huntington Disease. J Huntingtons Dis 4:251-60

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