title: Olfactory acuity is associated with mood and function in a pilot study of stable bipolar disorder patients.
abstract: OBJECTIVE
  Olfactory dysfunction is described in several neuropsychiatric disorders but there is little research on olfactory processing in bipolar disorder.
  
  
  METHODS
  We assessed odor detection threshold (sensitivity) and smell identification test scores, along with symptoms, cognition, and social function in 20 DSM-IV bipolar disorder patients and 44 control subjects.
  
  
  RESULTS
  The patient and control groups had similar demographic measures, intelligence, and mean olfaction scores, but significantly differed in social domains, including adjustment, function, and anxiety. Odor detection sensitivity showed significantly opposite correlations for the depressive and manic mood domains in bipolar disorder (r to z = 2.83, p = 0.005). Depressive symptoms were related to increased sensitivity (the ability to detect odors at a lower concentration) and mania symptoms were related to decreased sensitivity for odor detection. Increased sensitivity for odor detection also predicted significantly better employment (r = -0.642, p = 0.024), whereas less sensitivity was associated with social avoidance (r = 0.702, p =0.024) and social fear (r = 0.610, p = 0.046).
  
  
  CONCLUSIONS
  Diminished odor detection sensitivity predicted mania and social avoidance, whereas more sensitive odor detection predicted more depressive symptoms but better employment functioning in bipolar disorder patients. Odor acuity may be an illness state marker of mood syndromes in bipolar disorder. Alternatively, differences in odor acuity may identify heterogeneous subgroups within the bipolar spectrum. Longitudinal assessments in a large, sex-stratified sample are needed to understand the implications of odor sensitivity in patients with bipolar disorder.
authors.affiliation: Department of Psychiatry, New York University (NYU) School of Medicine, New York, NY, USA.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Hardy
authors.forename: Mary
authors.initials: M
authors.lastname: Rosedale
authors.forename: Julie W
authors.initials: JW
authors.lastname: Messinger
authors.forename: Karine
authors.initials: K
authors.lastname: Kleinhaus
authors.forename: Nicole
authors.initials: N
authors.lastname: Aujero
authors.forename: Hanna
authors.initials: H
authors.lastname: Silva
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Goetz
authors.forename: Deborah
authors.initials: D
authors.lastname: Goetz
authors.forename: Jill
authors.initials: J
authors.lastname: Harkavy-Friedman
authors.forename: Dolores
authors.initials: D
authors.lastname: Malaspina
mesh_terms: D000328:Adult; D000339:Affect; D001714:Bipolar Disorder / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000209:etiology*; D010865:Pilot Projects; D012684:Sensory Thresholds; D012903:Smell; D012917:Social Adjustment; D012919:Social Behavior