Ketosis and bipolar disorder: controlled analytic study of online reports
Ketosis and bipolar disorder: controlled analytic study of online reports
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DOI：
10.1192/bjo.2019.49
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发表时间：
2019-07-04
期刊：
影响因子：
5.4
通讯作者：
Campbell, Harry
中科院分区：
文献类型：
--
作者：
Campbell, Iain H.;Campbell, Harry
在线双相情感障碍论坛的成员经常报告生酮饮食的情绪稳定经验，生酮饮食传统上用于治疗癫痫。我们审查了这些报告的性质和范围。目的探讨生酮饮食与双相情感障碍患者情绪稳定之间的关系。方法：我们对在线论坛上关于饮食干预（生酮、富含omega-3或素食）对274名双相情感障碍患者情绪稳定变化的先验分类的情绪影响的自由文本评论进行了观察性分析研究。结果有141篇（85.5%）关于生酮饮食对情绪稳定有积极影响的自由文本评论。生酮饮食在一段时间内显著的情绪稳定或症状缓解的报告明显高于其他饮食（93/165,56.4%,95% CI 48.4-64.1）和14/94,14.9%,95% CI 8.4-23.7)，优势比7.4,95% CI 3.8-14.1, P < 0.0001)，许多人有详细的改善报告，其中一些持续时间较长（数月至数年）。其他报告的关联包括抑郁发作较少（41.2%,95% CI 30.6-52.4）；思维和言语清晰度提高（28.2%,95% CI 19.0-39.0）；能量增加（25.9,95% CI 17.0-36.5）；体重减轻（25.9%,95% CI 17.0-36.5）。结论：尽管基于网上自我报告的观察性数据存在固有的局限性，但相关强度和持续益处的报告支持了生酮饮食与情绪稳定有益作用相关的假设。在可以进行对照试验来检验这一假设之前，应谨慎解释这一数据。这些初步观察结果与双相情感障碍的线粒体功能障碍因素大致一致，酮绕过糖酵解和三羧酸循环之间的阻滞。
BackgroundMembers of online bipolar disorder forums often report experiences of mood-stabilisation on the ketogenic diet, which has traditionally been used in the treatment of epilepsy. We examined the nature and extent of such reports.AimsTo investigate associations between a ketogenic diet and mood stabilisation among individuals with bipolar disorder.MethodWe undertook an observational analytic study of free-text comments in online forums about mood effects of dietary interventions (ketogenic, omega-3 enriched or vegetarian) classified by a priori categories of change in mood stabilisation in 274 people with bipolar disorder.ResultsThere were 141 (85.5%) free-text comments on ketogenic diets that reported a positive impact on mood stabilisation. Reports of significant mood stabilisation or remission of symptoms over a period were substantially higher for a ketogenic diet than for other diets (93/165, 56.4%, 95% CI 48.4-64.1) v. 14/94, 14.9%, 95% CI 8.4-23.7), odds ratio 7.4, 95% CI 3.8-14.1, P < 0.0001), many with detailed reports of the improvements experienced and several lasting for extended periods (months to years). Other reported associations included fewer episodes of depression (in 41.2%, 95% CI 30.6-52.4 of individuals); improved clarity of thought and speech (28.2%, 95% CI 19.0-39.0); increased energy (25.9, 95% CI 17.0-36.5); and weight loss (25.9%, 95% CI 17.0-36.5).ConclusionsDespite the inherent limitations of the observational data based on self-reports posted online, the association strength and reports of sustained benefit support a hypothesis of a ketogenic diet being associated with beneficial effects on mood stabilisation. Caution should be exercised in interpreting this data until a controlled trial can be carried out to examine this hypothesis. These preliminary observations are generally consistent with a mitochondrial dysfunction component to bipolar disorder aetiology with ketones bypassing a block between glycolysis and the tricarboxylic acid cycle.