BACKGROUND: Night work and shift work scenarios are increasing in modern society. Instability in the sleep-wake rhythm is an important risk factor for triggering episodes of bipolar disorder. Extreme chronotype has negative effects on shift work ("shift-worker syndrome"). Effects of night or shift work on patients with bipolar disorder and extreme chronotype are not well understood. CASE REPORT: A patient with bipolar II disorder and extreme morning type followed a stable work schedule for a significant period of time, maintaining a stable mood. After changing to a night-shift schedule, depressive symptoms developed. When the night-shift schedule was stopped, her mental state normalised. CONCLUSIONS: This case highlights the possibility of a sensitizing role of chronotype in triggering episodes of bipolar disorder after the sleep-wake rhythm has been disrupted by night work or shift work. The evaluation of a person's capability to perform night work or shift work should take into account psychiatric disorders and chronotype as well as physical conditions.
BACKGROUND: Night work and shift work scenarios are increasing in modern society. Instability in the sleep-wake rhythm is an important risk factor for triggering episodes of bipolar disorder. Extreme chronotype has negative effects on shift work ("shift-worker syndrome"). Effects of night or shift work on patients with bipolar disorder and extreme chronotype are not well understood. CASE REPORT: A patient with bipolar II disorder and extreme morning type followed a stable work schedule for a significant period of time, maintaining a stable mood. After changing to a night-shift schedule, depressive symptoms developed. When the night-shift schedule was stopped, her mental state normalised. CONCLUSIONS: This case highlights the possibility of a sensitizing role of chronotype in triggering episodes of bipolar disorder after the sleep-wake rhythm has been disrupted by night work or shift work. The evaluation of a person's capability to perform night work or shift work should take into account psychiatric disorders and chronotype as well as physical conditions.
Authors: Michael J McCarthy; John F Gottlieb; Robert Gonzalez; Colleen A McClung; Lauren B Alloy; Sean Cain; Davide Dulcis; Bruno Etain; Benicio N Frey; Corrado Garbazza; Kyle D Ketchesin; Dominic Landgraf; Heon-Jeong Lee; Cynthia Marie-Claire; Robin Nusslock; Alessandra Porcu; Richard Porter; Philipp Ritter; Jan Scott; Daniel Smith; Holly A Swartz; Greg Murray Journal: Bipolar Disord Date: 2021-12-10 Impact factor: 5.345