Biological rhythms are independently associated with quality of life in bipolar disorder

Abstract

BackgroundEvidence suggests that patients with bipolar disorder (BD) experience biological rhythm disturbances; however, no studies have examined the impact of this disruption on quality of life (QOL). The aim of this study is to investigate the influence of biological rhythm, depressive symptoms, sleep quality, and sleep medication use on QOL in BD.MethodsEighty BD subjects (44 depressed and 36 euthymic) completed questionnaires assessing QOL (WHOQOL-BREF), biological rhythm disruption (BRIAN), depressive symptoms (MADRS), and sleep quality (PSQI). The impact of biological rhythm disturbance, depressive symptoms severity, sleep quality, and sleep medication use on QOL was determined with multiple regression analyses.ResultsBRIAN (β = −0.31, t = −2.73, p < 0.01), MADRS (β = −0.30, t = −2.93, p < 0.01), and sleep medication use (β = −0.45, t = −2.55, p < 0.05) were significant predictors of QOL in this model (F4, 75 = 20.28; p < 0.0001). The relationship of these factors with subdomains of QOL showed that poorer social QOL was associated with greater biological rhythm disturbance (β = −0.43, t = −3.66, p < 0.01) and sleep medication use (β = −0.49, t = −2.35, p < 0.01), providing support for the social rhythm theory of BD. Physical QOL was associated with depression (β = −0.30, t = −2.93, p < 0.01) and biological rhythm disruption (β = −0.31, t = −2.73, p < 0.01). Main limitations include the cross-sectional assessment and the lack of objective measures of biological rhythms in relation to QOL.ConclusionsDisruption in biological rhythm is associated with poor QOL in BD, independent of sleep disturbance, sleep medication use, and severity of depression. Treatment strategies targeting regulation of biological rhythms, such as sleep/wake cycles, eating patterns, activities, and social rhythms, are likely to improve QOL in this population.

Clinical evaluation of biological rhythm domains in patients with major depression

“…Additionally, previous studies have considered disruptions of biological rhythm as a single symptom, or were conducted only in patients with bipolar disorder. 14,20,21,28,29 Only one recent study evaluated the effect of specific biological rhythm domains on unipolar depression, finding significant disruption in all biological rhythm domains (sleep, activity, social, and eating) and BRIAN-Total score both in patients with MDD and in those with bipolar disorder, compared to healthy controls. 21 However, this study was population-based, only included young adults (age 18-24 years), and did not take into consideration drug use or other confounders.…”

“…BRIAN was validated in patients with mood disorders and provides comprehensive data. Studies using this instrument found that biological rhythm disturbances influence psychosocial functioning, 18 the severity of depression, 19 and quality of life 20 in patients with mood disorders. A recent study assessed the disruption of biological rhythm in a community sample of young adults with mood disorders (major depression and bipolar disorder), 21 while others were conducted including only patients with bipolar disorder.…”

“…A recent study assessed the disruption of biological rhythm in a community sample of young adults with mood disorders (major depression and bipolar disorder), 21 while others were conducted including only patients with bipolar disorder. [18][19][20] However, there is a lack of research evaluating the relationship between severity of symptoms and domains of biological rhythm in patients with major depression.…”

Construction of a biological rhythm assessment scale for children

“…3 Furthermore, biological rhythm impairment in adults has been associated with poor functioning and quality of life. 4 Therefore, it is essential to have an assessment instrument for kids, to allow a better understanding of the reactions and the effects that this disturbance may have on our body and mental health in children.…”

A powerful non‐pharmacologic treatment for mania – virtually

“…Might they be more effective in patients with a tendency toward staying up late (so‐called evening chronotype – which some , but not all , studies have found more common in patients with bipolar disorder)? Could amber lenses, already demonstrated to be capable of preserving melatonin production , help to stabilize the biological rhythm disturbances recently shown to lower quality of life in bipolar disorder ? Hopefully, the Norwegian study will spur such research.…”