Preventive effect of morning light exposure on relapse into depressive episode in bipolar disorder

Esaki, Yuichi; Obayashi, Kenji; Saeki, Keigo; Fujita, Kiyoshi; Iwata, Nakao; Kitajima, Tsuyoshi

doi:10.1111/acps.13287

Cited by 7 publications

(7 citation statements)

References 36 publications

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“…In the Cox proportional hazards model, we analyzed the L5 parameter using natural log-transformed continuous variables given that it was not normally distributed. In multivariable analysis, we calculated the hazard ratio by simultaneously adjusting the variables associated with mood episodes, including age (per year), gender (female/male), residual mood symptoms (yes/no), multiple mood episodes within the past year before the baseline assessment (yes/no), total sleep time (abnormal sleep time [<6 or ≥9 h]/normal sleep time [≥6 and <9 h]), sleep efficiency (high/low, category based on the median value), and daytime illuminance (high/low) [11,[23][24][25][26][27]. We checked the multicollinearity among independent variables using the Spearman's rank correlation coefficient.…”

Section: Discussionmentioning

confidence: 99%

Association between circadian activity rhythms and mood episode relapse in bipolar disorder: a 12-month prospective cohort study

et al. 2021

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A significant proportion of patients with bipolar disorder experience mood episode relapses. We examined whether circadian activity rhythms were associated with mood episode relapses in patients with bipolar disorder. This prospective cohort study included outpatients with bipolar disorder who participated in a study titled “Association between the Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study.” The participants’ physical activity was objectively assessed using a wrist-worn accelerometer over 7 consecutive days for the baseline assessment and then at the 12-month follow-up for mood episode relapses. The levels and timing of the circadian activity rhythms were estimated using a cosinor analysis and a nonparametric circadian rhythm analysis. Of the 189 participants, 88 (46%) experienced mood episodes during follow-up. The Cox proportional hazards model adjusting for potential confounders showed that a robust circadian activity rhythm, including midline-estimating statistic of rhythm (MESOR) and amplitude by cosinor analysis and 10 consecutive hours with the highest amplitude values (M10) by the nonparametric circadian rhythm analysis, was significantly associated with a decrease in mood episode relapses (per counts/min, hazard ratio [95% confidence interval]: MESOR, 0.993 [0.988–0.997]; amplitude, 0.994 [0.988–0.999]; and M10, 0.996 [0.993–0.999]). A later timing of the circadian activity rhythm (M10 onset time) was significantly associated with an increase in the depressive episode relapses (per hour; 1.109 [1.001–1.215]). We observed significant associations between circadian activity rhythms and mood episode relapses in bipolar disorder.

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Section: Discussionmentioning

confidence: 99%

Association between circadian activity rhythms and mood episode relapse in bipolar disorder: a 12-month prospective cohort study

et al. 2021

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“…Adjustment was needed for many potential confounders associated with mood episodes; therefore, propensity scoring was employed to determine the hazard ratio (HR) for mood episodes in the multivariable model. The propensity score in relation to average LAN (≥3 lux vs. <3 lux) was calculated from the logistic regression model, which included the variables associated with mood episodes, such as age (per year), gender (female or male), employment status (yes or no), type of bipolar disorder (I or II), anxiety disorder (yes or no), substance use disorder (yes or no), depressive symptoms (MADRS score of ≥8 points), manic symptoms (high or low; categories were based on the median value), multiple mood episodes during the year before baseline assessment (yes or no), body mass index (per kg/m 2 ), bedtime (per hour), rising time (per hour), total sleep time (per min), sleep efficiency (per %), daytime physical activity (per counts/min), daytime illuminance (per lux), and day length (per min) 1,6,7,9,16‐21 …”

Section: Methodsmentioning

confidence: 99%

Effect of nighttime bedroom light exposure on mood episode relapses in bipolar disorder

Esaki

Obayashi

Saeki

et al. 2022

Acta Psychiatr Scand

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Objective A previous cross‐sectional study reported that nighttime light is associated with increased occurrence of manic symptoms in bipolar disorder; however, the longitudinal association between nighttime light and subsequent mood episode relapses remains unclear. We determined whether bedroom nighttime light was associated with mood episode relapses in patients with bipolar disorder. Methods This prospective cohort study included 172 outpatients with bipolar disorder who participated in an Association between the Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. A portable photometer was used to measure illuminance in the bedroom from bedtime to rising time during 7 consecutive nights for baseline assessment. Then, the participants were assessed at a 2‐year follow‐up for mood episode relapses. Results Of the 172 participants, 157 (91%) completed the 2‐year follow‐up, and 39 (22%) experienced manic or hypomanic episodes (with or without mixed features), during that time. In the Cox proportional‐hazards model, the hazard ratio (HR) for manic/hypomanic episode relapses was significantly higher when the average nighttime illuminance was ≥3 lux (n = 71) than when it was <3 lux (n = 101; HR, 2.54; 95% confidence interval (CI), 1.33–4.84). In the multivariable model adjusted for a propensity score in relation to nighttime light, the relationship remained significant (HR, 2.17; 95% CI, 1.04–4.52). The association between nighttime light and depressive episode relapses was not significantly different. Conclusions Keeping the bedroom dark at night may prevent hypomanic and manic episodes.

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“…Individuals struggling with bipolar disorder carry a significant burden of general medical comorbidity, which contributes significantly to the overarching socioeconomic impact [ 14 ]. Furthermore, the estimated lifetime prevalence of bipolar disorder in Europe is 3.9%, highlighting the large number of people affected by this condition [ 15 ]. Caregivers supporting individuals with bipolar disorder face burdens that impact health, mental well-being, and financial situations, emphasizing the far-reaching impact on the support network of these patients [ 16 ].…”

Section: Socioeconomic Associations Between Psychiatric Illness and C...mentioning

confidence: 99%

Socioeconomic Burden of Psychiatric Cancer Patients: A Narrative Review

Więckiewicz,

Weber,

Florczyk

et al. 2024

Cancers

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This comprehensive review article examines the complex overlap of affective disorders, psychoses, addictions, anxieties, post-traumatic stress disorder, and somatic symptom disorder in the context of cancer patients, and highlights the intricate interplay between psychiatric and oncological diagnoses. Based on extensive literature, it highlights the profound socioeconomic burdens that result from the coexistence of these disorders. The analysis includes the increased healthcare costs, impaired adherence to treatment, and reduced quality of life for individuals struggling with the co-occurrence of psychiatric and cancer-related problems. By synthesizing the available data through a narrative inquiry, the report aims to provide a nuanced understanding of the multiple socioeconomic challenges faced by this vulnerable patient population. The synthesis of information provides valuable insights for healthcare professionals, policymakers, and researchers alike. The aim is to promote the development of more effective and integrated care strategies tailored to the specific needs of people navigating the complicated environment of psychiatric and cancer diagnoses. Ultimately, this review should enable progress in the provision of holistic, patient-centered care for this complex intersection of health conditions.

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Preventive effect of morning light exposure on relapse into depressive episode in bipolar disorder

Cited by 7 publications

References 36 publications

Association between circadian activity rhythms and mood episode relapse in bipolar disorder: a 12-month prospective cohort study

Association between circadian activity rhythms and mood episode relapse in bipolar disorder: a 12-month prospective cohort study

Effect of nighttime bedroom light exposure on mood episode relapses in bipolar disorder

Socioeconomic Burden of Psychiatric Cancer Patients: A Narrative Review

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