Xavier Estrada-Prat1, Ion Álvarez-Guerrico2, María J Bleda-Hernández3, Ester Camprodon-Rosanas4, Santiago Batlle-Vila4, Elena Pujals-Altes3, María T Nascimento-Osorio4, Luís M Martín-López5, Enric Álvarez-Martínez6, Víctor Pérez-Solá7, Soledad Romero-Cela8. 1. Institut de Neuropsiquiatria i Addiccions (INAD), Centre de Salut Mental Infantil i Juvenil (CSMIJ) Sant Martí-La Mina, Parc de Salut Mar, Barcelona Departament de Psiquiatria i de Medicina Legal, Universitat Autònoma de Barcelona. 2. Departament de Neurologia i Neurofisiologia Clínica (Unitat del Son), Hospital del Mar, Barcelona. 3. Instituto de Química Avanzada de Catalunya, Consejo Superior de Investigaciones Científicas (CSIC), Barcelona. 4. Institut de Neuropsiquiatria i Addiccions (INAD), Centre de Salut Mental Infantil i Juvenil (CSMIJ) Sant Martí-La Mina, Parc de Salut Mar, Barcelona. 5. INAD, CSMIJ Ciutat Vella, Parc de Salut Mar, Barcelona. 6. Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Barcelona. 7. INAD, Hospital del Mar, Barcelona. 8. Servei de Psiquiatria i Psicologia Infantil i Juvenil, Hospital Clínic i Provincial, Barcelona.
Abstract
INTRODUCTION: Decreased need for sleep has been proposed as a core symptom of mania and it has been associated with the pathogenesis of Bipolar Disorder. The emergence of Disruptive Mood Dysregulation Disorder (DMDD) as a new diagnostic has been controversial and much has been speculated about its relationship with the bipolar spectrum. REM sleep fragmentation could be a biomarker of affective disorders and it would help us to differentiate them from other disorders. METHOD: Polysomnographic cross-sectional study of children with DMDD, bipolar disorder and Attention Deficit Hyperactivity Disorder (ADHD). All participants underwent a psychiatric semi-structured interview to obtain the diagnosis, comorbidities and primary sleep disorders. DMDD’s sample was performed following DSM5 criteria. GOALS: Perform polysomnography in a sample of bipolar, DMDD and ADHD children and compare their profiles to provide more evidence about the differences or similarities between bipolar disorder and DMDD. RESULTS: Bipolar group had the highest REM density values while ADHD had the lowest. REM density was not statiscally different between bipolar phenotypes. REM density was associated with antidepressant treatment, episodes of REM and their interaction. REM latency was associated with antipsychotic treatment and school performance. Bipolar patients had higher scores on the depression scale than DMDD and ADHD groups. CONCLUSIONS: No significant differences between the two compared affective disorders were found. However there were differences in REM density between bipolar and ADHD groups. REM sleep study could provide a new theoretical framework to better understand the pathogenesis of pediatric bipolar disorder.
INTRODUCTION: Decreased need for sleep has been proposed as a core symptom of mania and it has been associated with the pathogenesis of Bipolar Disorder. The emergence of Disruptive Mood Dysregulation Disorder (DMDD) as a new diagnostic has been controversial and much has been speculated about its relationship with the bipolar spectrum. REM sleep fragmentation could be a biomarker of affective disorders and it would help us to differentiate them from other disorders. METHOD: Polysomnographic cross-sectional study of children with DMDD, bipolar disorder and Attention Deficit Hyperactivity Disorder (ADHD). All participants underwent a psychiatric semi-structured interview to obtain the diagnosis, comorbidities and primary sleep disorders. DMDD’s sample was performed following DSM5 criteria. GOALS: Perform polysomnography in a sample of bipolar, DMDD and ADHDchildren and compare their profiles to provide more evidence about the differences or similarities between bipolar disorder and DMDD. RESULTS: Bipolar group had the highest REM density values while ADHD had the lowest. REM density was not statiscally different between bipolar phenotypes. REM density was associated with antidepressant treatment, episodes of REM and their interaction. REM latency was associated with antipsychotic treatment and school performance. Bipolar patients had higher scores on the depression scale than DMDD and ADHD groups. CONCLUSIONS: No significant differences between the two compared affective disorders were found. However there were differences in REM density between bipolar and ADHD groups. REM sleep study could provide a new theoretical framework to better understand the pathogenesis of pediatric bipolar disorder.
Authors: Elisabet Blok; M Elisabeth Koopman-Verhoeff; Daniel P Dickstein; Jared Saletin; Annemarie I Luik; Jolien Rijlaarsdam; Manon Hillegers; Desana Kocevska; Tonya White; Henning Tiemeier Journal: Child Adolesc Psychiatry Ment Health Date: 2022-02-17 Impact factor: 3.033