OBJECTIVES: Theoretical accounts and psychological interventions for bipolar disorder indicate that disruption of circadian rhythms is important, both in affective episodes and as a vulnerability factor in subsyndromal periods. This study aims at assessing both circadian activity and sleep patterns using actigraphy within a bipolar sample experiencing low levels of subsyndromal symptoms. It is hypothesized that such participants will display circadian activity disruption in spite of low levels of symptoms. METHODS: This study employed a mixed design with cross-sectional assessment of mood and week-long (7-day) recording of actigraphy data. All clinical participants were psychiatric outpatients within a UK NHS Hospital. Nineteen bipolar patients and 19 age- and gender-matched controls wore an actigraph for 7 days to obtain sleep and circadian activity data. SCID was used to confirm DSM-IV diagnostic status. Self-report measures of mood were obtained from both groups. RESULTS: Bipolar patients were found to have less stable and more variable circadian activity patterns than controls. Regression analysis indicated that variability alone was a significant independent predictor of diagnostic group. There was evidence from raw activity data that bipolar patients were also less active than controls. These differences were not associated with levels of subsyndromal symptoms. Bipolar patients did not differ from controls on any of the sleep indices used. CONCLUSIONS: Circadian activity disruption is apparent in bipolar patients even when not acutely ill. This finding is not associated with the presence of sleep disturbance. Should such patterns be replicated interventions to address both circadian instability and individual attributions for the effects of such instability are likely to be relevant to successful psychological interventions.
OBJECTIVES: Theoretical accounts and psychological interventions for bipolar disorder indicate that disruption of circadian rhythms is important, both in affective episodes and as a vulnerability factor in subsyndromal periods. This study aims at assessing both circadian activity and sleep patterns using actigraphy within a bipolar sample experiencing low levels of subsyndromal symptoms. It is hypothesized that such participants will display circadian activity disruption in spite of low levels of symptoms. METHODS: This study employed a mixed design with cross-sectional assessment of mood and week-long (7-day) recording of actigraphy data. All clinical participants were psychiatric outpatients within a UK NHS Hospital. Nineteen bipolarpatients and 19 age- and gender-matched controls wore an actigraph for 7 days to obtain sleep and circadian activity data. SCID was used to confirm DSM-IV diagnostic status. Self-report measures of mood were obtained from both groups. RESULTS:Bipolarpatients were found to have less stable and more variable circadian activity patterns than controls. Regression analysis indicated that variability alone was a significant independent predictor of diagnostic group. There was evidence from raw activity data that bipolarpatients were also less active than controls. These differences were not associated with levels of subsyndromal symptoms. Bipolarpatients did not differ from controls on any of the sleep indices used. CONCLUSIONS: Circadian activity disruption is apparent in bipolarpatients even when not acutely ill. This finding is not associated with the presence of sleep disturbance. Should such patterns be replicated interventions to address both circadian instability and individual attributions for the effects of such instability are likely to be relevant to successful psychological interventions.
Authors: Lucia Pagani; Patricia A St Clair; Terri M Teshiba; Susan K Service; Scott C Fears; Carmen Araya; Xinia Araya; Julio Bejarano; Margarita Ramirez; Gabriel Castrillón; Juliana Gomez-Makhinson; Maria C Lopez; Gabriel Montoya; Claudia P Montoya; Ileana Aldana; Linda Navarro; Daniel G Freimer; Brian Safaie; Lap-Woon Keung; Kiefer Greenspan; Katty Chou; Javier I Escobar; Jorge Ospina-Duque; Barbara Kremeyer; Andres Ruiz-Linares; Rita M Cantor; Carlos Lopez-Jaramillo; Gabriel Macaya; Julio Molina; Victor I Reus; Chiara Sabatti; Carrie E Bearden; Joseph S Takahashi; Nelson B Freimer Journal: Proc Natl Acad Sci U S A Date: 2015-12-28 Impact factor: 11.205
Authors: Michael J McCarthy; Heather Wei; Caroline M Nievergelt; Andrea Stautland; Adam X Maihofer; David K Welsh; Paul Shilling; Martin Alda; Ney Alliey-Rodriguez; Amit Anand; Ole A Andreasson; Yokesh Balaraman; Wade H Berrettini; Holli Bertram; Kristen J Brennand; Joseph R Calabrese; Cynthia V Calkin; Ana Claasen; Clara Conroy; William H Coryell; David W Craig; Nicole D'Arcangelo; Anna Demodena; Srdjan Djurovic; Scott Feeder; Carrie Fisher; Nicole Frazier; Mark A Frye; Fred H Gage; Keming Gao; Julie Garnham; Elliot S Gershon; Kara Glazer; Fernando Goes; Toyomi Goto; Gloria Harrington; Petter Jakobsen; Masoud Kamali; Elizabeth Karberg; Marisa Kelly; Susan G Leckband; Falk Lohoff; Melvin G McInnis; Francis Mondimore; Gunnar Morken; John I Nurnberger; Sarah Obral; Ketil J Oedegaard; Abigail Ortiz; Megan Ritchey; Kelly Ryan; Martha Schinagle; Helle Schoeyen; Candice Schwebel; Martha Shaw; Tatyana Shekhtman; Claire Slaney; Emma Stapp; Szabolcs Szelinger; Bruce Tarwater; Peter P Zandi; John R Kelsoe Journal: Neuropsychopharmacology Date: 2018-11-16 Impact factor: 7.853