Clinical Psychopharmacology and Neuroscience Papers in Press available online.

Does post-traumatic stress disorder impact treatment outcomes within a randomised controlled trial of mitochondrial agents for bipolar depression?
Samantha Emmi Russell 1, Anna L Wrobel 1,2, Melanie M Ashton 1, Alyna Turner 1,3,*, Mohammadreza Mohebbi 1,4, Michael Berk 1,2,5, Sue Cotton 2,7, Seetal Dodd 1,7,8, Chee H Ng 6, Gin S Malhi 9,10,11, Olivia M Dean 1,5
1Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, P.O. Box 281, Geelong, 3220, Australia, 2Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, 3052, Australia., 3Florey Institute for Neuroscience and Mental Health, University of Melbourne, Kenneth Myer Building, 30 Royal Parade, Parkville, 3052, Australia, 4Department of Psychiatry, University of Melbourne, The Melbourne Clinic, 130 Church St Richmond Australia 3121, 5Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Rd, Parkville, 3052, Australia, 6The University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia, 7Academic Department of Psychiatry, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065 Australia, 8CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065 Australia, 9NICM Health Research Institute, Western Sydney University, 158 Hawkesbury Rd, Westmead, NSW 2045, Australia, 10School of Medicine and Public Health, Faculty of Health, The University of Newcastle, Callaghan, 2308, Australia
Objective: Bipolar disorder (BD) often co-occurs with post-traumatic stress disorder (PTSD), yet few studies have investigated the impact of PTSD on BD on treatment outcomes. The aim of this nested study was to explore symptoms and functioning outcomes between those with BD alone and those with BD+PTSD.
Methods: Participants (n = 148) with bipolar depression were randomised to: (i) N-acetylcysteine alone; (ii) a combination of nutraceuticals; (iii) or placebo (in addition to treatment as usual) for 16 weeks (+4 weeks discontinuation). Differences between BD and BD+PTSD on symptoms and functioning at five timepoints, as well as on the rate of change from baseline to week 16 and baseline to week 20, were examined.
Results: There were no baseline differences between BD and BD+PTSD apart from the BD group being significantly more likely to be married (p = 0.01). There were also no significant differences between BD and BD+PTSD on symptoms and functioning.
Conclusions: There were no differences in clinical outcomes over time within the context of an adjunctive randomised controlled trial between those with BD alone compared to those with comorbid BD+PTSD. However, differences in psychosocial factors may provide targets for areas of specific support for people with comorbid BD+PTSD.
Accepted Manuscript [Submitted on 2022-04-04, Accepted on 2022-06-05]