The effect of systematic antidepressant treatments in the early stages on sleep and impulsivity in bipolar euthymic patients: A cross-sectional study

Mingjin Wang; Xuguang An; Dongyu Han; Xiaofei Hou; Chenghao Yang

doi:10.1371/journal.pone.0322274

Peer Review History

Original SubmissionNovember 8, 2024
8 Nov 2024 Author Response https://doi.org/10.1371/journal.pone.0322274.r001
5 Feb 2025 Decision Letter - Giuseppe Marano, Editor -->PONE-D-24-50851-->-->The impact of systematic antidepressant treatments in early stage on sleep and impulsivity in bipolar euthymic patients: A cross-sectional study-->-->PLOS ONE Dear Dr. Yang, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== I kindly request that you carefully review the English language and make any necessary corrections. In addition, please revise the manuscript according to the comments and suggestions provided by the reviewers. I also encourage you to consider incorporating more recent references where appropriate to ensure your work reflects the current state of the field. 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Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions -->Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. --> Reviewer #1: Partly Reviewer #2: Yes ******** -->2. Has the statistical analysis been performed appropriately and rigorously? --> Reviewer #1: Yes Reviewer #2: Yes ****** -->3. Have the authors made all data underlying the findings in their manuscript fully available? 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #1: No Reviewer #2: Yes ****** -->5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #1: First of all, I would like to thank Authours for providing this best topic which is neglected part in psychiatry. Next, i need to tell you some concerns related to the manuscript . 1. There is no concestance ammong long title and short title. Some time you say the impacts and at the some time you used the effects. Because, the two words have some differences. 2. You did not stated how did you calculated the sample size and it is not clear. Samplig sizee is the main issue in scientific study. 3. You didnot clarify the Allocation ratio among control and intervention group? 4. The sampling techniques didnot stated? 5. The rationale of these study is not deeply mentioned or its shallow 6. You used DSM-IV text revision for diagnosis annd as evaluation criteria, whiich is not currently in use. Since 2017, DSM-5 is in use and why you didnot consider DSM-5 ? 7. You put none under acknowledge part. Is there any reason why you did so? 8. Please review all body part of these manuscript and check gramatic error, and sysematicallly connect with each other. Regards! Reviewer #2: Hello. Thank you for the opportunity to read your manuscript. I think the findings are somewhat expected but interesting in this population. It would have been more helpful to have more details about the duration and dosages of antidepressants as you have mentioned as well as more objective data about the sleep disturbances. ****** -->6. 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Revision 1
25 Feb 2025 Author Response Dear prof. Marano, Thank you very much for the invitation to revise and resubmit our manuscript, entitled "The effect of systematic antidepressant treatments in the early stages on sleep and impulsivity in bipolar euthymic patients: A cross-sectional study" to the PLoS One (ref: PONE-D-24-50851). We appreciate all efforts you have made and would like to thank the reviewers for their comments, which are very detailed and constructive and helped us to significantly improve the quality of the manuscript. In our response, we provided point-by-point responses to all comments and made all additions and changes to the manuscript using track changes. Furthermore, we have corrected the grammatical errors and refined the expression throughout the manuscript. We hope that you will find this revised version of our manuscript suitable for publication in the journal of PLoS One. Yours sincerely, Also, on behalf of the coauthors, Chenghao Yang Point by point response to reviewers Reviewer 1. First of all, I would like to thank Authours for providing this best topic which is neglected part in psychiatry. Next, i need to tell you some concerns related to the manuscript. 1. There is no concestance ammong long title and short title. Some time you say the impacts and at the some time you used the effects. Because, the two words have some differences. Response: Thanks for reviewer’s careful reading and constructive feedback regarding the consistency in terminology. We have recognized that although these terms are quite related, there are nuancedly distinct in the context of the current topic. In this regard, we agree with the suggestion from the reviewer and choose the “effect” as the unified term because it emphasizes the basic and neutral relationship between antidepressant treatments and observed outcomes. Accordingly, we have adjusted the long and short titles in the title page. 2. You did not stated how did you calculated the sample size and it is not clear. Samplig sizee is the main issue in scientific study. Response: Thank the reviewer for pointing out this important issue. As reviewer suggested, sample size calculation is crucial for the feasibility and scientific validity of a research, as it ensures that the study is adequately powered to detect real effects, while avoiding unnecessary resource waste or over-sampling, thereby enhancing the accuracy and reliability of the research. The study protocol, including the section on sample size calculation, had been published previously. We have referred it to reference No.33 in the section of “setting and subjects”. Actions: (page 5, line 119-120) Please refer to the published study protocol for experimental details. 3. You didnot clarify the Allocation ratio among control and intervention group? Response: Thanks for reviewer’s comment. Since our research was a cross-sectional study in which subjects did not receive any interventions and were grouped according to whether they had received systematic antidepressant treatments in the early stages rather than being assigned at random. So, we would say that it is inappropriate to engage the principle of “allocation ratio” here. 4. The sampling techniques didnot stated? Response: Thank you for raising this important issue. We recruited patients with bipolar disorder and grouped them according to whether they had received systematic treatment with antidepressants in the early stages. This grouping method is not random; instead, it deliberately selects patients with specific characteristics for the study, which is the purposive sampling. As described in the “Procedures and clinical assessment” section, the researchers involved in screening and allocation were different from those responsible for administering scale rating and data analysis, in order to decrease subjective bias. We have mentioned this and made a subtle revision in the “Setting and subjects” section. Please let us know if further information is required. Actions: (page 4, line 99-102; page 5, line 109-110) Based on a history of systematic antidepressant treatments in the early stages, patients were consecutively divided into the systematic antidepressant treatment (AT) group and the no systematic antidepressant (NT) group. They had been in remission for at least 4 weeks prior to engage in the study. 5. The rationale of these study is not deeply mentioned or its shallow Response: We appreciate the reviewer for this helpful advice. If I am not mistaken, you are referring to the background of this study not being adequately explained. The primary goal was to explore the potential associations between antidepressant use, sleep and impulsivity of bipolar euthymic patients. The relationships between any of two variables are indirect or ambiguous. In this regard, it is valuable to explore it in view of the significant delay in diagnosis of bipolar disorder and widespread use of antidepressants before being properly diagnosed. Objectively speaking, the current topic has been overlooked, with all the focus placed on how to diagnose bipolar disorder early. However, the results from relevant studies are far from satisfactory. Therefore, it is important to address the effect of delayed diagnosis of bipolar disorder and inappropriate antidepressant treatment, which is the motivation and starting point for our research. 6. You used DSM-IV text revision for diagnosis annd as evaluation criteria, whiich is not currently in use. Since 2017, DSM-5 is in use and why you didnot consider DSM-5 ? Response: Thanks for reviewer’s valuable suggestion. The current study was conceptualized in 2019 and established in the mid-2020, by which time the DSM-5 and SCID-5 had not yet been adopted in China. Furthermore, the diagnostic criteria for bipolar disorder have not significantly changed between the DSM-IV-TR and DSM-5, except for the reclassification of the mixed episode as mixed features. We would say that the engagement of DSM-IV-TR in the study did not make significant bias for recruiting bipolar patients. 7. You put none under acknowledge part. Is there any reason why you did so? Response: We appreciate the reviewer's attention to acknowledgment section. We have revised it. Actions: (page15, line 332-333) We would like to express our gratitude to all the participants for their support and dedication to this study. 8. Please review all body part of these manuscript and check gramatic error, and sysematicallly connect with each other. Response: We thank the reviewer for these valuable suggestions. We have corrected the grammatical errors and refined the English writing throughout the manuscript. We have not highlighted every minor revision in the manuscript. Reviewer 2. Hello. Thank you for the opportunity to read your manuscript. I think the findings are somewhat expected but interesting in this population. It would have been more helpful to have more details about the duration and dosages of antidepressants as you have mentioned as well as more objective data about the sleep disturbances. Thank the reviewer for this insightful suggestion. We agree with the reviewer’s opinion and have illustrated it in detail in section of “limitations”. First, detailed information would improve the reliability of the research findings and support the broader dissemination and application of the results. Our study is a cross-sectional design that retrospectively collects medication data, including information from several years ago, which presents challenges in accurately obtaining all relevant details. We are concerned that inconsistencies in the level of detail could introduce bias. As a result, we have excluded such data from the analysis and discussion. Second, as you suggested, the objective data on the sleep, such as polysomnographic recording, would strengthen the reliability of the research results. But it is not feasible in terms of our experimental funding and conditions. Moreover, PSQI is commonly used in assessing sleep quality. Actions: (page15, line 317-319) Future research should incorporate longitudinal observations, utilize objective indicators, and minimize confounding factors to enhance the study’s validity. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0322274.r003
19 Mar 2025 Decision Letter - Giuseppe Marano, Editor The effect of systematic antidepressant treatments in the early stages on sleep and impulsivity in bipolar euthymic patients: A cross-sectional study PONE-D-24-50851R1 Dear Dr. Yang, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Giuseppe Marano Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions -->Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.--> Reviewer #1: All comments have been addressed ******** -->2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. --> Reviewer #1: Yes ****** -->3. Has the statistical analysis been performed appropriately and rigorously? --> Reviewer #1: Yes ****** -->4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.--> Reviewer #1: Yes ****** -->5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.--> Reviewer #1: Yes ****** -->6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)--> Reviewer #1: You came with nice topic and you did well. No more comments for you. All comments were incorporated Regards! ****** -->7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .--> Reviewer #1: No ******** https://doi.org/10.1371/journal.pone.0322274.r004
Formally Accepted
Acceptance Letter - Giuseppe Marano, Editor PONE-D-24-50851R1 PLOS ONE Dear Dr. Yang, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Giuseppe Marano Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0322274.r005

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