The bipolarity of light and dark: A review on Bipolar Disorder and circadian cycles

Abreu, T.; Bragança, M.

doi:10.1016/j.jad.2015.07.017

Cited by 120 publications

(89 citation statements)

References 136 publications

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“…When we consider the diagnosis of bipolar disorder as a whole, the significant clinical variable for the onset of an affective episode is not seasonal pattern but, rather, greater sunlight exposure, which has also been shown in recent reviews 9,36 and clinical trials. 14,21,37 In a clinical study assessing climatic variables and admissions for mania, Volpe et al, concluded that the most frequent association is with luminosity: higher temperatures were only significantly involved in regions where the hottest months coincide with the more daylight.…”

Section: Discussionmentioning

confidence: 83%

“…This result underscores the higher probability of admission during the pronounced photoperiod change between spring and summer, which agrees with numerous recent studies confirming a strong seasonal pattern in bipolar disorder. [9][10][11][12][13][14][15][16]21,[34][35][36][37] This finding, in light the DSM-5's focus on seasonal pattern in bipolar disorder, prompted the following question: is seasonality really the most incisive clinical parameter for assessing the onset of bipolar disorder, or is it, rather, greater exposure to sunlight?…”

Section: Discussionmentioning

confidence: 99%

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Bipolar disorders: is there an influence of seasonality or photoperiod?

Aguglia

Borsotti

Maina

2017

Rev. Bras. Psiquiatr.

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Objective: To increase understanding of the influence of photoperiod variation in patients with bipolar disorders. Methods: We followed a sample of Italian bipolar patients over a period of 24 months, focusing on inpatients. All patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital in Orbassano (Turin, Italy) between September 1, 2013 and August 31, 2015 were recruited. Sociodemographic and clinical data were collected. Results: Seven hundred and thirty patients were included. The admission rate for bipolar patients was significantly higher during May, June and July, when there was maximum sunlight exposure, although no seasonal pattern was found. Patients with (hypo)manic episodes were admitted more frequently during the spring and during longer photoperiods than those with major depressive episodes. Conclusions: Photoperiod is a key element in bipolar disorder, not only as an environmental factor but also as an important clinical parameter that should be considered during treatment.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Bipolar disorders: is there an influence of seasonality or photoperiod?

Aguglia

Borsotti

Maina

2017

Rev. Bras. Psiquiatr.

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“…-Sleep disorders [delayed sleep phase syndrome (Skene et al, 1999), non-24 h sleep/ wake disorder and sleep/wake schedule disorder (Dagan & Abadi, 2001;Uchiyama & Lockley, 2015), recurrent hypersomnia (Billiard et al, 2011), SW sleep disorder (Schwartz & Roth, 2006)] -SW intolerance (Andlauer & Reinberg, 1979;Reinberg et al, 1983Reinberg et al, , 1988) -Delirium (Fitzgerald et al, 2013) -Peptic ulcer disease (Moore & Merki, 1997;Moore & Smolensky, 1991) -Affective disorders [depression (BicakovaRocher et al, 1996;Rosenwasser & WirtzJustice, 1997;Salgado-Delgado et al, 2011), mania (Klemfuss & Kripke, 1989), bipolar disorder (Abreu & Bragança, 2015)] -Parkinson's disease (Bordet et al, 2003;Fertl et al, 1991;Willison et al, 2013) -Autism spectrum disorder (Botbol et al, 2013;Tordjman et al, 2015) -Smith-Magenis syndrome (Chen et al, 2015) -Fatal familial insomnia [autosomal dominant prion brain disease (Montagna et al, 1995;Portaluppi et al, 1994aPortaluppi et al, , 1994bPortaluppi et al, , 1995] -Kidney failure, especially end-stage disease (Biasioli et al, 1988;Farfel et al, 1978;Hillier et al, 1980;Koch et al, 2009;Mojón et al, 2013;Portaluppi et al, 1990;Raff & Trivedi, 2012;Russcher et al, 2015;Wheatley et al, 1989) -Pulm...…”

Section: Discussionmentioning

confidence: 99%

Circadian disruption: New clinical perspective of disease pathology and basis for chronotherapeutic intervention

Smolensky

Hermida

Reinberg

et al. 2016

Chronobiology International

155

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Biological processes are organized in time as innate rhythms defined by the period (τ), phase (peak [Φ] and trough time), amplitude (A, peak-trough difference) and mean level. The human time structure in its entirety is comprised of ultradian (τ < 20 h), circadian (20 h > τ < 28 h) and infradian (τ > 28 h) bioperiodicities. The circadian time structure (CTS) of human beings, which is more complicated than in lower animals, is orchestrated and staged by a brain central multioscillator system that includes a prominent pacemaker - the suprachiasmatic nuclei of the hypothalamus. Additional pacemaker activities are provided by the pineal hormone melatonin, which circulates during the nighttime, and the left and right cerebral cortices. Under ordinary circumstances this system coordinates the τ and Φ of rhythms driven by subservient peripheral cell, tissue and organ clock networks. Cyclic environmental, feeding and social time cues synchronize the endogenous 24 h clocks and rhythms. Accordingly, processes and functions of the internal environment are integrated in time for maximum biological efficiency, and they are also organized and synchronized in time to the external environment to ensure optimal performance and response to challenge. Artificial light at night (ALAN) exposure can alter the CTS as can night work, which, like rapid transmeridian displacement by air travel, necessitates realignment of the Φ of the multitude of 24 h rhythms. In 2001, Stevens and Rea coined the phrase "circadian disruption" (CD) to label the CTS misalignment induced by ALAN and shift work (SW) as a potential pathologic mechanism of the increased risk for cancer and other medical conditions. Current concerns relating to the effects of ALAN exposure on the CTS motivated us to renew our long-standing interest in the possible role of CD in the etiopathology of common human diseases and patient care. A surprisingly large number of medical conditions involve CD: adrenal insufficiency; nocturia; sleep-time non-dipping and rising blood pressure 24 h patterns (nocturnal hypertension); delayed sleep phase syndrome, non-24 h sleep/wake disorder; recurrent hypersomnia; SW intolerance; delirium; peptic ulcer disease; kidney failure; depression; mania; bipolar disorder; Parkinson's disease; Smith-Magenis syndrome; fatal familial insomnia syndrome; autism spectrum disorder; asthma; byssinosis; cancers; hand, foot and mouth disease; post-operative state; and ICU outcome. Poorly conceived medical interventions, for example nighttime dosing of synthetic corticosteroids and certain β-antagonists and cyclic nocturnal enteral or parenteral nutrition, plus lifestyle habits, including atypical eating times and chronic alcohol consumption, also can be causal of CD. Just as surprisingly are the many proven chronotherapeutic strategies available today to manage the CD of several of these medical conditions. In clinical medicine, CD seems to be a common, yet mostly unrecognized, pathologic mechanism of human disease as are the many effective chronotherapeutic int...

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“…Disruption of sleep patterns and circadian rhythms is frequently associated with bipolar disorder (33,34). To evaluate the circadian rhythms of the mutant mice, we utilized running wheels.…”

Section: δE24-/-mentioning

confidence: 99%