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A specific group of patients with diagnostic conversion from depression to bipolar disorder and finally to dementia as a mental GSK‐3 disease: A hypothesis
Author(s) -
Terao Takeshi,
Ishii Nobuyoshi,
Hirakawa Hirofumi
Publication year - 2020
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12875
Subject(s) - bipolar disorder , dementia , depression (economics) , psychology , psychiatry , gsk 3 , disease , clinical psychology , lithium (medication) , medicine , genetics , kinase , biology , economics , macroeconomics
Objectives To focus on a specific group of patients whose diagnoses were changed from unipolar depression to bipolar disorder, and finally to dementia. Methods Qualitative review of the relevant articles. Results A substantial portion of patients with unipolar depression manifest manic and/or hypomanic episodes, resulting in a change of diagnoses to bipolar disorder. Further, a substantial portion of bipolar patients develop dementia. Previous research suggests that genetic variants in the glycogen synthase kinase 3β (GSK‐3β) gene are associated with early onset of unipolar depression, a subset of which may be bipolar depression, with three SNPs (rs334555, rs119258668, and rs11927974) identified. Notably, another promotor SNP (rs334558) of the GSK‐3β gene is reportedly associated with unipolar depression, bipolar disorders, and dementia. Additionally, lithium, which is reported to inhibit GSK‐3, is generally accepted to be effective for bipolar disorder and recently reported to be effective for dementia. Conclusions There is a specific group of patients whose diagnoses longitudinally change from depression to bipolar disorder and finally to dementia, and GSK‐3 may be a common etiological factor in these diseases and in diagnostic conversions.