Meredith E Rumble1, Daniel Dickson2, W Vaughn McCall3, Andrew D Krystal4, Doug Case5, Peter B Rosenquist3, Ruth M Benca6. 1. Department of Psychiatry, University of Wisconsin, Madison, United States. Electronic address: rumble@wisc.edu. 2. Department of Psychiatry, University of Wisconsin, Madison, United States. 3. Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, United States. 4. Department of Psychiatry, University of California, San Francisco, United States; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States. 5. Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States. 6. Department of Psychiatry and Human Behavior, University of California, Irvine, United States.
Abstract
BACKGROUND: Epidemiological data have demonstrated seasonal and circadian patterns of suicidal deaths. Several reviews and meta-analyses have confirmed the relationship between sleep disturbance and suicidality. However, these reviews/meta-analyses have not focused on seasonal and circadian dysfunction in relation to suicidality, despite the common presence of this dysfunction in patients with mood disorders. Thus, the current literature review analyzed studies investigating person-specific chronotype, seasonality, and rhythmicity in relation to suicidal thoughts and behaviors. METHODS: Study authors reviewed articles related to individual-level chronotype, seasonality, and rhythmicity and suicidality that were written in English and not case reports or reviews. RESULTS: This review supports a relationship between an eveningness chronotype, greater seasonality, and decreased rhythmicity with suicidal thoughts and behaviors in those with unipolar depression, as well as in other psychiatric disorders and in children/adolescents. LIMITATIONS: These findings need to be explored more fully in mood disordered populations and other psychiatric populations, in both adults and children, with objective measurement such as actigraphy, and with chronotype, seasonality, and rhythmicity as well as broader sleep disturbance measurement all included so the construct(s) most strongly linked to suicidality can be best identified. CONCLUSIONS: Eveningness, greater seasonality, and less rhythmicity should be considered in individuals who may be at risk for suicidal thoughts and behaviors and may be helpful in further tailoring assessment and treatment to improve patient outcome.
BACKGROUND: Epidemiological data have demonstrated seasonal and circadian patterns of suicidal deaths. Several reviews and meta-analyses have confirmed the relationship between sleep disturbance and suicidality. However, these reviews/meta-analyses have not focused on seasonal and circadian dysfunction in relation to suicidality, despite the common presence of this dysfunction in patients with mood disorders. Thus, the current literature review analyzed studies investigating person-specific chronotype, seasonality, and rhythmicity in relation to suicidal thoughts and behaviors. METHODS: Study authors reviewed articles related to individual-level chronotype, seasonality, and rhythmicity and suicidality that were written in English and not case reports or reviews. RESULTS: This review supports a relationship between an eveningness chronotype, greater seasonality, and decreased rhythmicity with suicidal thoughts and behaviors in those with unipolar depression, as well as in other psychiatric disorders and in children/adolescents. LIMITATIONS: These findings need to be explored more fully in mood disordered populations and other psychiatric populations, in both adults and children, with objective measurement such as actigraphy, and with chronotype, seasonality, and rhythmicity as well as broader sleep disturbance measurement all included so the construct(s) most strongly linked to suicidality can be best identified. CONCLUSIONS: Eveningness, greater seasonality, and less rhythmicity should be considered in individuals who may be at risk for suicidal thoughts and behaviors and may be helpful in further tailoring assessment and treatment to improve patient outcome.
Authors: William V McCall; Ruth M Benca; Peter B Rosenquist; Nagy A Youssef; Laryssa McCloud; Jill C Newman; Doug Case; Meredith E Rumble; Steven T Szabo; Marjorie Phillips; Andrew D Krystal Journal: Am J Psychiatry Date: 2019-09-20 Impact factor: 18.112
Authors: Meredith E Rumble; William V McCall; Daniel A Dickson; Andrew D Krystal; Peter B Rosenquist; Ruth M Benca Journal: J Clin Sleep Med Date: 2020-08-15 Impact factor: 4.062
Authors: Alessandro Miola; Veronica Dal Porto; Tal Tadmor; Giovanni Croatto; Paolo Scocco; Mirko Manchia; Andre F Carvalho; Michael Maes; Eduard Vieta; Fabio Sambataro; Marco Solmi Journal: Acta Psychiatr Scand Date: 2021-08-25 Impact factor: 7.734