Homocysteine as a potential biomarker in bipolar disorders: a critical review and suggestions for improved studies

Introduction: Homocysteine levels have been associated with major depression, but associations with bipolar disorder remain less clear. Some data suggest homocysteine levels have potential as a biomarker of treatment response; however the literature is mixed.

Areas covered: Oxidized forms of homocysteine can be potentially neurotoxic leading to glutamate toxicity, apoptotic transformation and neurodegenerative processes. High homocysteine may be a risk biomarker for bipolar disorders, but the empirical base remains too weak for firm conclusions. This review discusses the current literature for homocysteine levels as a biomarker.

Expert opinion: It is premature to foreclose the utility of homocysteine levels as a biomarker for bipolar disorder due the methodological inadequacies in the existing literature. These methodological design issues include lack of control for the confounding variables of concurrent medication, phase of bipolar disorder, gender, age, nutritional status, thyroid, liver and renal function, smoking or lean body mass. Well-powered association studies with confounder control could help shed more light on the important clinical question of homocysteine's utility as a biomarker in bipolar disorder. Future experiments are needed to examine the outcome of interventions modulating homocysteine for treating bipolar disorder. Only prospective randomized control trials will provide definitive evidence of the utility of homocysteine as a biomarker or therapeutic target.

Influence of light exposure during early life on the age of onset of bipolar disorder

BACKGROUND: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. METHODS: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4 N and 70.7 N, and 1.2 S and 41.3 S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. RESULTS: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. CONCLUSIONS: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.

Interview with Mustakim Adipradja

Mustakim Adipradja is an Indonesian who studied Architecture in Australia at the University of Melbourne in the 1960s. He married an Australian, has travelled the world and worked in Australia, Singapore and Indonesia. The interview is conducted in Indonesian by Dr Ahmad Suaedy from the Abdurrahman Wahid Center for Interfaith Dialogue and Peace at Universitas Indonesia and was recorded on 2 January 2014. This set comprises: An interview recording in two parts, a transcript of the interview in Indonesian, a transcript of the interview translated into English.

Interview with Sumbangan Baja

Dr Sumbangan Baja is an Indonesian who studied for a PhD in Australia at Sydney University on an Australian Development Scholarship, 1998-2001. He completed a Masters degree at Massey University in New Zealand, on a New Zealand Government scholarship. He met his wife in New Zealand - she was also an Indonesian student. The interview is conducted in English on 24 October 2014 by Dr Jemma Purdey of Deakin University and Dr Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia. This set comprises: an interview recording, a photograph, and a timed summary.

Interview with Inge Christanti

Inge Christanti is an Indonesian who studied at Curtin University in 2004-2006. She studied on an Australian Agency for Intenational Development (AusAID) Scholarship and completed a Masters in Human Rights Education. The interview was conducted in Indonesian on 30 May 2014 by Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia. This set comprises: an interview recording, a transcript of the interview (also in Indonesian), and a photograph.

Interview with Elisabeth (Nophie) Dewi

Elisabeth (Nophie) Dewi is an Indonesian who studied at Victoria University in 2006-2010. She studied on an Australian International Development Assistance Bureau (AIDAB) Scholarship. The interview was conducted in English by Dr Jemma Purdey of Deakin University and Dr Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia. The interview was recorded on 30 April 2014. This set comprises: an interview recording, a photograph, and a timed summary.

Interview with Dewi Fajarningsih

Dewi Fajarningsih is an Indonesian who studied at The University of Queensland in 2009-2010. She studied on an Australian Development Scholarship (ADS) and completed a Master of Biotechnology. The interview was conducted in Indonesian on 13 May 2014 by Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia. This set comprises: an interview recording, a transcript of the interview in Indonesian, a transcript of the interview translated into English, and a photograph.

Interview with IR Taufik Fauzi

IR Taufik Fauzi is an Indonesian who studied at The University of Queensland in 1994-1998. He completed his PhD of Agriculture in Australia having previously studied in Canada. The interview was conducted by Dr. Jemma Purdey of Deakin University and Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia on 5 August 2014. An interview recording, a photo, and a timed summary.

Interview with Masdar Hilmy

Masdar Hilmy is an Indonesian who studied at Melbourne University in 2004-2007. He studied on an Australian Development Scholarship (ADS) and completed a PhD in Islamic studies. The interview was conducted in English by Dr. Jemma Purdey of Deakin University and Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Univertas Indonesia on 31 May 2014. This set comprises: an interview recording, a photograph, and a timed summary.

Interview with Istiadah Istiadah

Istiadah Istiadah is an Indonesian who studied at Monash University in 1992-1994. She studied on an Australian International Development Assistance Bureau (AIDAB) Scholarship and completed a Masters in Language Education. The interview was conducted in English on 23 October 2014 by Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia. This set comprises: an interview recording and a transcript of the interview.

Interview with I. Komang Damar Jaya

I. Komang Damar Jaya is an Indonesian who studied in Australia on two occasions; at Sydney University in 1990-1992 and at La Trobe University in 1997-2000 (although some of this period was spent in Indonesia conducting research). On both occasions he studied on Australian Agency for International Development (AusAID) scholarships and completed his Masters degree in Agricultural Science in Sydney and completed his PhD in the same area during his time at La Trobe despite challenges presented by the length of his scholarship. The interview was conducted by Dr. Jemma Purdey of Deakin University and Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Univertas Indonesia. This set comprises: an interview recording, a timed summary and a photograph.

Interview with Dr. Enri Haryanti Kahfi

Dr. Enri Haryanti Kahfi is an Indonesian who studied at Flinders University in 2002-2006. She studied on an Australian Development Scholarship (ADS) and completed a PhD in Gender Studies. The interview was conducted in English by Dr. Jemma Purdey of Deakin University and Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia on 30 April 2014. This set comprises: an interview recording, a timed summary and a photo.

Interview with M. Tahir Kasmani

M. Tahir Kasmani is an Indonesian who studied at Flinders University in 1987-1990. He completed a PhD in Social Demography, specifically focussing on rural women and development in Indonesia. The interview was conducted in English by Dr. Jemma Purdey of Deakin University and Dr. Ahmah Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia on 24 October 2014. This set comprises: an interview recording, a photograph, and a timed summary.

Interview with Koesmarihati

Koesmarihati is an Indonesian who studied at the University of Tasmania in 1962-1963. She studied on a Colombo Plan Scholarship and completed a Bachelor of Engineering. She also returned to live in Australia in 1968-1974. The interview was conducted in Indonesian on 3 January 2014 by Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia. This set comprises: an interview recording, a transcript of the interview, a transcript translated into English and a photograph.

Interview with R. Inge Komardjaja

R. Inge Komardjaja is an Indonesian who studied at The University of New South Wales in 1991-1995. She studied on an Australian International Development Assistance Bureau (AIDAB) Scholarship and completed PhD in Women's Studies. The interview was conducted in English by Dr. Jemma Purdey of Deakin University and Dr. Ahmad Suaedy of the Abdurrahman Wahid Centre for Inter-faith Dialogue and Peace at Universitas Indonesia on 30 April 2014. This set comprises: an interview recording, a timed summary and a photograph.