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375
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Introduction
My research aims to bridge psychopathology and neurobiology from the early stages to the chronic stages into clinical settings and thereby
i) identify clinically relevant risk and resilience factors in affective disorders
ii) develop new combination of medical, psychological and social individualized treatment
iii) translate these findings into clinical practice
Current institution
Publications
Publications (375)
Background
Traditional treatment for affective disorders primarily focuses on symptom management through pharmacotherapy and psychotherapy and rarely addresses co-existing physical impairments.
Methods
This randomized controlled trial assessed the impact of a six-month multimodal intervention (AWARE) on physical health in patients with bipolar and...
Background
Oxidative stress may be involved in the pathophysiology of bipolar disorder (BD). Malondialdehyde (MDA), a product of fatty acid peroxidation has been proposed as a trait marker of BD associated with familial risk. However, little is known about MDA levels in young patients newly diagnosed with BD and their unaffected first-degree relati...
Background
Impaired emotion regulation has been proposed as a putative endophenotype in bipolar disorder (BD). Functional magnetic resonance imaging (fMRI) studies investigating this in unaffected first-degree relatives (UR) have thus far yielded incongruent findings. Hence, the current paper examines neural subgroups among UR during emotion regula...
Background
Antidepressants are commonly prescribed for mood disorders. Epidemiological studies suggest antidepressant use may be associated with cataracts and glaucoma. We aim to investigate the association between antidepressants and cataracts and glaucoma.
Methods
Data was collected from the United States Food and Drug Administration Adverse Eve...
Background
Electroconvulsive therapy (ECT) is a highly effective treatment for severe depression. However, its utilization is limited to the most severely ill patients due to stigma, healthcare provider unfamiliarity, and concerns regarding cognitive side effects. Erythropoietin (EPO) is a promising add-on treatment during ECT due to its potential...
Objective
Many psychotropic drugs are highly associated with related weight gain. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established anti-obesity and glucose-lowering agents. Preliminary evidence also indicates they are fit for purpose in mitigating psychotropic drug-related weight gain (PDWG). This systematic review aims to synth...
Introduction
Accumulating data support the association between increased inflammation and bipolar disorder (BD), and preliminary data suggest that augmentation with low-dose aspirin (LDA) may protect against the onset and deterioration of BD via anti-inflammatory pathways. The A-bipolar randomised controlled trial (RCT) aims to investigate whether...
Background
Nicotine use and nicotine use disorder (NUD) are the leading causes of preventable death in the United States. Persons with mental disorders (e.g., bipolar disorder) are differentially susceptible to nicotine use. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are indicated for type 2 diabetes mellitus (T2DM) and obesity and show p...
In Denmark, approximately 5% of new mothers experience postpartum depression, potentially hindering a child’s care and stimulation for ideal social-emotional development. This literary review explores the impact of maternal postpartum depression on a child’s social-emotional development and confirms that maternal postpartum depression potentially h...
Background
There is a compelling need for innovative intervention strategies for patients with affective disorders, given their increasing global prevalence and significant associated disability and impaired functioning. This study aimed to investigate whether a comprehensive multimodule individualized intervention (AWARE), targeting known mediator...
Introduction:
Bipolar disorder (BD), a mood disorder with recurrent affective episodes and a strong genetic basis is frequently associated with significant comorbidities, both physical and psychiatric, yet its neurobiology remains unclear. Recent evidence underscores oxidative stress as a pivotal factor linking BD to its comorbidities, prompting a...
Background
Relatives of patients with bipolar disorder (BD) often experience emotional burden with stress and depressive symptoms that again increase the likelihood of destabilization and relapses in the patient. The effects of group-based psychoeducation have not been investigated in large-scale real-world settings. We are currently conducting a l...
Objective s
This study aimed to investigate the neural underpinnings of emotional cognition subgroups in recently diagnosed patients with bipolar disorder (BD) and change over time over a 15‐month follow‐up period.
Methods
Patients and healthy controls (HC) underwent emotional and nonemotional cognitive assessments and functional magnetic resonanc...
Background
There is a significant contribution of genetic factors to the etiology of bipolar disorder (BD). Unaffected first-degree relatives of patients (UR) with BD are at increased risk of developing mental disorders and may manifest cognitive impairments and alterations in brain functional and connective dynamics, akin to their affected relativ...
Background: Lipids influence brain function and mental health. Understanding the role of apolipoproteins in affective disorders could provide valuable insights and potentially pave the way for novel therapeutic approaches. Methods: We examined the apolipoprotein E genotype and ApoE-levels, lipid profiles, and the correlation with cognition in 204 m...
ADHD and bipolar disorder (BP) commonly coexist, and both share key symptoms, depending on affective state and emotional dysregulation. The overlap poses diagnostic challenges and may lead to underdiagnoses. Comorbid cases exhibit worsened symptom burden, increased psychiatric morbidity, admissions, and suicide attempts. Treating BP before ADHD is...
Background
Persistent cognitive impairment is frequent across bipolar disorder (BD) and major depressive disorder (MDD), highlighting an urgent need for pro-cognitive treatments.
Aim
This study investigated effects of erythropoietin (EPO) on cognitive impairment and dorsal prefrontal cortex (dPFC) activity in affective disorders.
Methods
In this...
The link between childhood maltreatment and mood disorders is complex and involves multiple bio-psycho-social factors that affect multiple molecular pathways. The present narrative review aims to clarify the current understanding of the impact of childhood maltreatment on biomarkers in patients with mood disorders and their first-degree relatives....
Excessive oxidative stress-generated nucleoside damage seems to play a key role in bipolar disorder (BD) and may present a trait phenomenon associated with familial risk and is one of the putative mechanisms explaining accelerated atherosclerosis and premature cardiovascular diseases (CVD) in younger patients with BD. However, oxidative stress-gene...
Background:
Online self-harming and suicidal behavior is a novel and rapidly increasing phenomenon warranting comprehensive mapping of used research methods.
Aim:
To identify and map how knowledge on online self-harming and suicidal behavior is gathered, including how data are collected e.g. questionnaires and interviews.
Methods:
The review f...
Background
Cognitive impairments are prevalent across mood disorders and psychosis spectrum disorders, but there is a lack of real-life-like cognitive training programmes. Fully immersive virtual reality has the potential to ensure motivating and engaging cognitive training directly relevant to patients’ daily lives. We will examine the effect of a...
Background: Available evidence points to a possible role of Short Chain Fatty Acids (SCFAs) in mood disorders. This is the first systematic review to map the associations between SCFA levels and mood disorder symptoms.Methods: Following the PRISMA guidelines, the databases PubMed, Embase, and PsycINFO were searched for studies that assessed SCFA le...
This review investigates that up to 50% of patients with affective disorders present with impaired overall functioning, also in remitted phases. Nevertheless, functioning is often overlooked in clinical settings and not incorporated as an essential outcome in research. It is recommended clinically and in research to use the International Classifica...
Treatment‐resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision‐making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their...
Introduction
A substantial proportion of patients with bipolar disorder experience daily subsyndromal mood swings, and the term “mood instability” reflecting the variability in mood seems associated with poor prognostic factors, including impaired functioning, and increased risk of hospitalization and relapse.
During the last decade, we have develo...
Objective
Excessive oxidative stress-generated nucleoside damage seems to play a key role in bipolar disorder (BD) and may present a trait phenomenon associated with familial risk and is one of the putative mechanisms explaining accelerated atherosclerosis and premature cardiovascular diseases (CVD) in younger patients with BD. However, oxidative s...
Background:
Patients with bipolar disorder (BD) who are presenting with cognitive impairment and associated structural brain abnormalities have generally a poorer clinical outcome. This study aims to map the early longitudinal trajectories in brain structure and cognition in patients with recently diagnosed BD.
Methods:
Fully or partially remitt...
Introduction
A substantial proportion of patients with bipolar disorder experience daily subsyndromal mood swings, and the term ‘mood instability’ reflecting the variability in mood seems associated with poor prognostic factors, including impaired functioning, and increased risk of hospitalisation and relapse.
During the last decade, we have develo...
Background:
The aim of the study was to investigate whether patients with bipolar disorder (BD) in remission differ in personality traits compared with a healthy control group.
Methods:
A sample of patients with BD (n = 44) was compared with an individually matched control group (n = 44) using the Danish version of the Revised NEO Personality In...
Background:
Alterations and instability in mood and activity/energy has been associated with impaired functioning and risk of relapse in bipolar disorder. The present study aimed to investigate whether mood instability and activity/energy instability are associated, and whether these instability measures are associated with stress, quality of life...
Objective:
To investigate (i) the proportions of time with irritability and (ii) the association between irritability and affective symptoms and functioning, stress, and quality of life in patients with bipolar disorder (BD) and unipolar depressive disorder (UD).
Methods:
A total of 316 patients with BD and 58 patients with UD provided self-repo...
Background:
Low-grade inflammation and oxidative stress have been implicated as potential pathophysiological processes in bipolar disorder, but the underlying mechanism is unknown. Ferritin is a marker of iron stores and involved in redox processes and inflammation but its role in bipolar disorder is unclear.
Methods:
We investigated the possibl...
Bipolar disorder (BD) and major depressive disorder (MDD) are associated with cognitive and functional impairment. Cognitive impairment is often associated with dorsal prefrontal cortex (dPFC) hypo-activity, but the neuronal correlates of functional disability is largely unknown. In this study, 91 patients with affective disorders in full or partia...
Although cross-sectional studies show heterogeneity in emotional cognition in bipolar disorder (BD), the temporal course within subgroups is unclear. In this prospective, longitudinal study we assessed the trajectories of emotional cognition subgroups within a 16-month follow-up period in recently diagnosed BD patients compared to healthy controls...
Background
Individuals with mental health disorders have a higher risk of sexual problems impacting intimate relations and quality of life. For individuals with bipolar disorder (BD) the mood shifts might to a particular degree affect their sexual function with possible hypersexual interest during manic episodes and low sexual interest during depre...
Cognitive impairments are evident in remitted patients with bipolar disorder (BD) and their unaffected relatives (UR) compared to healthy controls (HC). However, the temporal course of cognition, and whether cognition is marked by neuroprogressive changes, remain unclear. In a large prospective study of newly diagnosed patients with BD, we assessed...
Objective:
Bipolar disorder (BD) is often a progressive mood disorder with a high prevalence of comorbid personality disorder (PD) ranging from 25 to 73 %. Previous studies have included patients with various illness duration of BD. Longer illness duration may be associated with increased prevalence of comorbid PD. This study investigated the prev...
Introduction
Clozapine and olanzapine are some of the most effective antipsychotics, but both are associated with weight gain and relevant metabolic disturbances, including pre-diabetes and diabetes. Non-pharmacological/behavioural interventions have had limited effects counteracting these adverse effects. Semaglutide, a glucagon-like peptide 1 rec...
Background:
Overall functioning is already impaired in patients newly diagnosed with bipolar disorder (BD) and, to a lesser degree, also in their unaffected first-degree relatives (UR). Further, aggregation of psychiatric disorders among the patients' first-degree relatives seems to be associated with higher illness burden and poorer prognosis. Ho...
Objectives:
Increased oxidative stress generated nucleoside damage seems to play a crucial role in bipolar disorder (BD) pathophysiology. It may contribute to accelerated ageing and reduced life expectancy in patients with BD.
Methods:
In the five-year prospective "Bipolar Illness Onset study", we investigated repeated measurements of oxidative...
Background
Bipolar disorder (BD) is associated with impairments in both emotional and non-emotional cognition. Recently, cognitive impairments have attracted increasing research interest as markers of prognosis and possible treatment targets in patients with BD. However, there is a paucity of studies investigating cognitive predictors of prognosis...
Background:
Postpartum depression (PPD) is a severe, debilitating mood disorder with consequences for both mothers and children, highlighting the need for rapid-acting and effective treatments for PPD. The aim of this narrative review is to synthesize the available literature on the administration of ketamine for PPD and propose ketamine as a viab...
Oxidative stress generated nucleoside damage seems to represent key pathophysiological mechanisms of bipolar disorder (BD). Likewise, mood and activity are core features of BD and can be reliably monitored using smartphone-based applications. The aim was to investigate whether oxidative stress generated nucleoside damage could reflect psychopatholo...
Introduction
BPD are often characterized by dependence, affectability, unpredictability, impulsivity and self-destructiveness. Paradoxically, the symptoms associated with BPD are the same behaviors that makes them difficult to accommodate by health professionals. They constitute the most excluded and stigmatized patient group.
Objectives
To gain k...
Introduction
The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioural, mental, and physical health, presumably with effects on patients with severe mental disorders.
Objectives
This study examines pandemic-related physical and mental health and (compensatory) behavioural changes, in pati...
Introduction
Several initiatives within psychiatric nursing targets Non-suicidal self-injury (NSSI) in DK, but none targets the new phenomenon Digital Self-harm. Digital self-harm involves the use of Social media (SoMe) to harm oneself for example by communicating condescending content about and to oneself through fake profiles, seeking out conflic...
Objectives:
Impaired emotion regulation is a key feature of bipolar disorder (BD) that presents during acute mood episodes and in remission. The neural correlates of voluntary emotion regulation seem to involve deficient prefrontal top-down regulation already at BD illness onset. However, the trajectory of aberrant neuronal activity during emotion...
Background
Childhood maltreatment is an established risk factor for incident unipolar disorder and bipolar disorder. It is separately observed that affective disorders (AD) are also associated with higher nucleoside damage by oxidation. Childhood maltreatment may induce higher levels of nucleoside damage by oxidation and thus contribute to the deve...
Enhanced oxidative stress-generated nucleoside damage may contribute to the increased cardiovascular disease mortality in patients with bipolar disorder (BD) but the association has never been investigated. We investigated the associations between oxidative stress-generated damage to DNA (8-oxodG) and RNA (8-oxoGuo), respectively, and three measure...
Anhedonia is a common, persistent, and disabling condition. However, available therapeutics primarily focus on the reduction of depressive and negative symptoms rather than amelioration of deficits in positive affect. As such, extant drug treatments remain largely ineffective in treating symptoms of anhedonia. Ketamine is a rapid-acting and novel t...
Neuroimaging studies of bipolar disorder (BD) generally involve comparison with healthy controls (HC), which may mask neurobiological variability within the disorder. This study aims to assess the neural underpinnings of potential subgroups of BD patients based on functional activity in the emotion regulation network and its relation to illness cha...
Throughout the COVID-19 pandemic, mental health of individuals with bipolar disorders (BD) is potentially more vulnerable, especially regarding COVID-19-related regulations and associated symptomatic changes. A multicentric online study was conducted in Austria, Germany, and Denmark during the COVID-19 pandemic. Overall, data from 494 participants...
Purpose
First-degree relatives of patients with bipolar disorder (BD) or major depressive disorder (MDD) are at risk of developing a major psychiatric disorder. However, preventive studies using pharmacological treatment of this high-risk group are sparse. The present study undertakes a scoping review to evaluate the literature of pharmacological t...
Background
Bipolar disorder (BD), and especially the mania phenotype, is characterized by heightened reward responsivity and aberrant reward processing. In this longitudinal fMRI study, we investigated neuronal response during reward anticipation as the computed expected value (EV) and outcome evaluation as reward prediction error (RPE) in recently...
Introduction:
Affective disorders are associated with impaired overall functioning and quality of life (QoL). Despite different medical and psychological treatment options, the prognosis remains largely unchanged. Consequently, the field needs new intervention strategies especially targeting patient groups with impaired functioning. This study aim...
Background
Individuals with mental health disorders have a higher risk of sexual problems impacting intimate relations and quality of life. For individuals with bipolar disorder (BD) the mood shifts might to a particular degree affect their sexual function with possible hypersexual interest during manic episodes and with low sexual interest during...
Background
Few studies have reported socio-economic status and functioning in patients newly diagnosed with bipolar disorder (BD) and their unaffected siblings (US).
Methods
Socio-economic status and functioning were compared in a cross-sectional clinical study including 382 patients newly diagnosed with BD, 129 of their US, and 200 healthy contro...
Background
Cognitive impairments exist in a large proportion of remitted patients with bipolar disorder (BD). However, no study has investigated the cognitive trajectories across neurocognitive subgroups of patients or their unaffected first-degree relatives (UR).
Methods
Newly diagnosed BD patients, UR and healthy controls (HC) underwent comprehe...
This narrative review addresses the challenges of how to identify and treat bipolar depression. Bipolar depression, i.e. depressive episode(s) as part of bipolar disorder, can be differentiated from unipolar depression only through the previous course of illness. A correct diagnosis therefore may be delayed. The pharmacotherapy of bipolar depressio...
Introduction:
Valid and reliable methods for diagnosing depression are essential. The present study aimed to test the performance of a new diagnostic interview for depression focusing on the core symptoms of depression.
Method:
We developed a diagnostic interview for depression: the CORE Diagnostic Interview, CORE-DI, which assesses each of the...
The COVID-19 pandemic affects both mentally healthy and ill individuals. Individuals with bipolar disorder (BD) constitute an especially vulnerable group. A multicentric online study was conducted in Austria, Denmark, and Germany after the first lockdown phase in 2020. In total, 117 healthy controls (HC) were matched according to age and sex to 117...
Background
It is of crucial importance to be able to discriminate unipolar disorder (UD) from bipolar disorder (BD), as treatments, as well as course of illness, differ between the two disorders. Aims: to investigate whether voice features from naturalistic phone calls could discriminate between 1) UD, BD, and healthy control individuals (HC); 2) d...
Background: The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioral, mental, and physical health, presumably with effects on patients with severe mental disorders. This study examines pandemic-related physical and mental health and (compensatory) behavioral changes, in patients with BD as...
Background
Voice features have been suggested as objective markers of bipolar disorder (BD).
Aims
To investigate whether voice features from naturalistic phone calls could discriminate between (1) BD, unaffected first-degree relatives (UR) and healthy control individuals (HC); (2) affective states within BD.
Methods
Voice features were collected...
Objectives
: The study herein aimed to assess the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), as well as general and abdominal obesity in patients with bipolar disorder (BD). We also compared the prevalence of T2DM and general obesity in patients with BD with age- and gender-matched healthy controls.
Method
: A s...
Importance
COVID-19 is associated with clinically significant symptoms despite resolution of the acute infection (i.e., post-COVID-19 syndrome). Fatigue and cognitive impairment are amongst the most common and debilitating symptoms of post-COVID-19 syndrome.
Objective
To quantify the proportion of individuals experiencing fatigue and cognitive imp...
Objective
This systematic literature search aimed to investigate the physical health status of first-degree relatives to patients with bipolar disorder. There is abundant evidence for familial aggregation of both bipolar disorders, cardiovascular and autoimmune diseases. However, a review gathering data on the physical health status in first-degree...
Objective
Mortality is increased in bipolar disorder due to both suicide and death by physical disorders, but it has never been investigated whether these mortalities translate into relatives to patients with bipolar disorder. The aim was to present the life expectancy and the overall mortality and mortality due to suicide and physical disorders am...
Background
Patients with major depressive disorder (MDD) or bipolar disorder (BD) exhibit difficulties with emotional cognition even during remission. There is evidence for aberrant emotional cognition in unaffected relatives of patients with these mood disorders, but studies are conflicting. We aimed to investigate whether emotional cognition in u...
Patients with mood disorders show heterogeneity in non-emotional cognition. However, it is unclear whether emotional cognition (EC) is characterised by similar heterogeneity. We aimed to investigate the heterogeneity in EC among remitted patients with mood disorders and explore its association with familial risk. Data from 269 partially or fully re...