{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:14:00Z","timestamp":1778804040819,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T00:00:00Z","timestamp":1494460800000},"content-version":"vor","delay-in-days":71,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81471375"],"award-info":[{"award-number":["81471375"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81671347"],"award-info":[{"award-number":["81671347"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The burden of illness associated with bipolar disorder (<jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>) warrants early pre\u2010emption\/prevention. Prediction models limited to psychiatric phenomenology have insufficient predictive power. Herein, we aimed to evaluate whether the presence of overweight\/obesity is associated with greater cognitive decline in individuals at high risk (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) or ultra high risk (<jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content>) for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis to investigate the moderational role of body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) on measures of cognitive function. Subjects between the ages of 8 and 28 years with a positive family history of BD were compared to age\u2010matched controls with a negative family history of BD. Subjects with at least one biological parent with bipolar I\/<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> disorder were further stratified into <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> status by the presence or absence, respectively, of subthreshold hypomanic, major depressive, attenuated psychotic, and\/or attention\u2010deficit\/hyperactivity disorder symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 36 individuals at <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>, 33 individuals at <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>, and 48 age\u2010matched controls were included in the analysis. Higher <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> was significantly associated with lower performance on measures of processing speed (i.e. Brief Assessment of Cognition in Schizophrenia\u2212symbol coding: <jats:italic>r<\/jats:italic>=\u2212.186, <jats:italic>P<\/jats:italic>=.047) and attention\/vigilance (i.e. Continuous Performance Test\u2212Identical Pairs: <jats:italic>r<\/jats:italic>=\u2212.257, <jats:italic>P<\/jats:italic>=.006). There were trends for negative correlations between <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and measures of working memory (i.e. Wechsler Memory Scale\u2010<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> Spatial Span: <jats:italic>r<\/jats:italic>=\u22120.177, <jats:italic>P<\/jats:italic>=.059) and overall cognitive function (i.e. Measurement and Treatment Research to Improve Cognition in Schizophrenia composite score: <jats:italic>r<\/jats:italic>=\u2212.157, <jats:italic>P<\/jats:italic>=.097). Negative associations between <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and cognitive performance were significantly stronger in the <jats:styled-content style=\"fixed-case\">UHR<\/jats:styled-content> group than in the <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> group, when compared to controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Individuals at varying degrees of risk for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> exhibit greater cognitive impairment as a function of co\u2010existing overweight\/obesity. Prediction models for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> may be substantively informed by including information related to overweight\/obesity and, perhaps, other general medical conditions that share pathology with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>. Our findings herein, as well as the salutary effects of bariatric surgery on measures of cognitive function in obese populations, provide the rationale for hypothesizing that mitigating excess weight in individuals at elevated risk for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> may forestall or prevent declaration of illness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12491","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T17:35:34Z","timestamp":1494524134000},"page":"128-134","source":"Crossref","is-referenced-by-count":32,"title":["Adverse effects of obesity on cognitive functions in individuals at ultra high risk for bipolar disorder: Results from the global mood and brain science initiative"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-2523","authenticated-orcid":false,"given":"Roger S.","family":"McIntyre","sequence":"first","affiliation":[{"name":"Department of Affective Disorders The Affiliated Brain Hospital of Guangzhou Medical University  Guangzhou China"},{"name":"Department of Psychiatry University of Toronto  Toronto ON Canada"},{"name":"Institute of Medical Science University of Toronto  Toronto ON Canada"},{"name":"Department of Pharmacology University of Toronto  Ontario ON Canada"},{"name":"Mood Disorders Psychopharmacology Unit University Health Network  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo B.","family":"Mansur","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Toronto  Toronto ON Canada"},{"name":"Mood Disorders Psychopharmacology Unit University Health Network  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yena","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Medical Science University of Toronto  Toronto ON Canada"},{"name":"Mood Disorders Psychopharmacology Unit University Health 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