Details

Autor(en) / Beteiligte

• Moon, Joung-Ho
• Cho, Chul-Hyun
• Son, Gi Hoon
• Geum, Dongho
• Chung, Sooyoung
• Kim, Hyun
• Kang, Seung-Gul
• Park, Young-Min
• Yoon, Ho-Kyoung
• Kim, Leen
• Jee, Hee-Jung
• An, Hyonggin
• Kripke, Daniel.F.
• Lee, Heon-Jeong

Titel

Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder

Ist Teil von

• EBioMedicine, 2016-09, Vol.11 (C), p.285-295

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2016

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD). Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~7hour advanced (equivalent to ~17hour delayed). Phases of 21 out of these 23 cases returned to normal by ~7hour delay along with treatment, but two out of 23 cases returned to normal by ~17hour advance. In three cases of mixed manic episodes, the phases were ~6–7hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~4–5hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD. •Bipolar disorder in acute mood episodes showed circadian dysregulation due to phase shifts which returned to normal after treatment.•Acute manias were ~ 7 h circadian phase advanced, mixed manias were > 6 h delayed, whereas depressions were 4-5 h delayed compared to the controls.•Circadian dysregulation due circadian rhythm phase shifts might be a pathophysiological mechanism of bipolar disorder. Bipolar disorder is a common mental disorder characterized by mood disturbances with alternating episodes of mania and depression. Circadian rhythms are rhythms of about 24h found in many body functions. We repeatedly measured circadian rhythms in bipolar disorder patients during hospitalization. Acute manic episodes were associated with circadian dysregulation of ~7hour phase advances, mixed manias were >6hour delayed, whereas bipolar depression was associated with 4–5hour phase delays compared to the controls. After treatment, the shifted rhythms recovered to the normal range. This study suggests that novel chronotherapy approaches based on our findings might be found useful for the prevention and treatment of bipolar disorder.