Seasonal variations in bipolar disorder admissions and the association with climate: A population-based study

Involuntary admissions in Italy: the impact of seasonality

“…Second, the most frequent diagnoses among involuntary admissions were bipolar disorder and related disorders and schizophrenia and other psychosis. Several authors confirmed our findings regarding both schizophrenia and other psychoses (Craw & Compton 2006;Bauer et al 2007;Pantusa et al 2007;Zhou et al 2015) and bipolar and related disorders (Lee et al 2007;Schuepbach et al 2008;Amr & Volpe 2012). Third, analyzing the monthly distribution of admissions, we observed a significant increase of involuntary hospitalizations during changes of season in particular in spring/summer with a peak in June.…”

“…In spring/summer, high hospitalization rates for manic episode (as principal reason for involuntary admission) are well stated, due to an increase in total sunshine hours and length of the average monthly days (Wang & Chen 2013;Abreu & Braganca 2015;Hochman et al 2016). Other studies showed, in addition to the main peak in spring/summer, a lower frequency of manic involuntary admissions in autumn (Cassidy & Carroll 2002;Lee et al 2002;Morken et al 2002;Volpe and Del Porto 2006;Lee et al 2007;Volpe et al 2010;Yang et al 2013;Geoffroy et al 2014). Furthermore, patients with bipolar disorder and seasonal-affective disorder have a higher light sensitivity compared to healthy controls and patients affected by major depressive disorder, as a result of melatoninergic, serotoninergic and dopaminergic neurotransmissions (Nathan et al 1999;Quera Salva et al 2011).…”

“…The Law states that compulsory admissions need to be formally authorized by the Mayor of the Municipality where the patient lives and can be only undertaken in acute psychiatric wards located in public general hospitals (Amaddeo et al 2012;Bauer et al 2007;Pantusa et al 2007;Zhou et al 2015;Donisi et al 2016). On the other hand, some studies have considered bipolar disorder, especially mixed and manic episodes, as one of the main diagnosis related to the involuntary admission (Lee et al 2007;Schuepbach et al 2008;Amr & Volpe 2012). Irregular chronobiology in terms of disrupted sleep and dysregulation of circadian rhythms with a greater seasonal fluctuations in mood and behaviour is a characteristic pattern of bipolar patients compared to unipolar depression patients or healthy controls (Geoffroy et al 2014).…”

“…Irregular chronobiology in terms of disrupted sleep and dysregulation of circadian rhythms with a greater seasonal fluctuations in mood and behaviour is a characteristic pattern of bipolar patients compared to unipolar depression patients or healthy controls (Geoffroy et al 2014). Patients suffering from manic episode have higher rates of admission during spring and summer (Lee et al 2007;Volpe et al 2010;Amr & Volpe 2012;Wang & Chen 2013;Hochman et al 2016). Furthermore, the prevalence of hospitalization in patients with bipolar depression has a main peak in early winter and a minor one in summer (Modai et al 1994;Avasthi et al 2001;Lee et al 2007;Amr & Volpe 2012;Yang et al 2013;Dominiak et al 2015).…”

“…Patients suffering from manic episode have higher rates of admission during spring and summer (Lee et al 2007;Volpe et al 2010;Amr & Volpe 2012;Wang & Chen 2013;Hochman et al 2016). Furthermore, the prevalence of hospitalization in patients with bipolar depression has a main peak in early winter and a minor one in summer (Modai et al 1994;Avasthi et al 2001;Lee et al 2007;Amr & Volpe 2012;Yang et al 2013;Dominiak et al 2015). Many studies examining bipolar patients, correlate the intensity of sunlight with a rise in the number of admissions for manic episode, and a decrease in hospitalization rates for depressive episode (Sayer et al 199;Modai et al 1994;Volpe & del Porto 2006;Dominiak et al 2015).…”