The Relationship between the Number of Manic Episodes and Oxidative Stress Indicators in Bipolar Disorder
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OBJECTIVE: Bipolar disorder (BD) is a chronic mood disorder characterized by recurrent episodes that has a lifetime prevalence of 0.4- 5.5%. The neurochemical mechanism of BD is not fully understood. Oxidative stress in neurons causes lipid peroxidation in proteins associated with neuronal membranes and intracellular enzymes and it may lead to dysfunction in neurotransmitter reuptake and enzyme activities. These pathological processes are thought to occur in brain regions associated with affective functions and emotions in BD. The relationship between the number of manic episodes and total oxidant-antioxidant capacity was investigated in this study. METHODS: Eighty-two BD patients hospitalized due to manic symptoms and with no episodes of depression were enrolled in the study. Thirty of the 82 patients had had their first episode of mania, and the other 52 patients had had two or more manic episodes. The control group included 45 socio-demographically matched healthy individuals. Serum total antioxidant capacity (TAC) and total oxidant capacity (TOC) measurements of the participants were performed. The oxidative stress index (OSI) was calculated by TOC/TAC. RESULTS: There were no significant differences in OSI scores between BD patients with first-episode mania and BD patients with more than one manic episode. However, OSI scores in both groups were significantly higher than in the control group. TOC levels of BD patients with first-episode mania were found to be significantly higher than TOC levels of BD patients with more than one manic episode and healthy controls. There were no significant differences in TAC levels between BD patients with first-episode mania and BD patients with more than one manic episode. TAC levels in both groups were significantly higher than in the control group. CONCLUSION: Significant changes in oxidative stress indicators were observed in this study, confirming previous studies. Increased levels of oxidants were shown with increased disease severity rather than with the number of manic episodes. Systematic studies, including of each period of the disorder, are needed for using the findings indicating deterioration of oxidative parameters.
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In patients with bipolar disorder, DNA oxidative damage is related to increased telomere shortening, translating into approximately 10-year acceleration of aging.
“It has been reported that DNA oxidative damage is related to increased telomere shortening in patients with BD; this translates into an approx. 10-year acceleration of aging (Akarsu et al. 2018).”
From Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging (2023) · cites this paper as Akarsu et al. 2018
Evaluation of oxidative stress markers in patients with bipolar disorder revealed increased values in serum and erythrocytes.
“Evaluation of oxidative stress markers in patients with bipolar disorder revealed their increased values in serum and erythrocytes (Akarsu et al. 2018).”
From Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging (2023) · cites this paper as Akarsu et al. 2018
Oxidative DNA damage and telomere shortening have been found to be increased in patients with bipolar disorder which has been estimated to accelerate aging by about 10 years.
“Interestingly, oxidative DNA damage and telomere shortening have been found to be increased in patients with bipolar disorder which in turn has been estimated to accelerate aging by about 10 years (Akarsu et al. 2018).”
From Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging (2023) · cites this paper as Akarsu et al. 2018
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- Authors
- Akarsu, S., Bolu, A., Aydemir, E., Zincir, S. B., Kurt, Y. G., Zincir, S., Erdem, M., & Uzun, Ö.
- Affiliations
- Gülhane Eğitim ve Araştırma Hastanesi (TR)
- Corresponding author
- Akarsu, Süleyman
- Venue
- Psychiatry Investigation
- Publisher
- Korean Neuropsychiatric Association
- Published
- 2018-05-25
- Volume
- 15
- Issue
- 5
- Pages
- 514-519
- ISSN
- 1738-3684 (ISSN-L)
- 1976-3026
- PMC
- PMC5975995
- OpenAlex
- W2800685153
- Cited by
- 35
- References
- 43
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 8 · 2023: 5 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 2
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Psychiatry Investigation (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- bipolar disorder, manic episodes, oxidative stress, total antioxidant capacity, total oxidant capacity, oxidative stress index, first-episode mania, disease severity, serum biomarkers
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