Bipolar disorder (BD) is a serious mood disorder associated with circadian rhythm abnormalities. Risk for BD is genetically encoded and overlaps with systems that maintain circadian rhythms. Lithium is an effective mood stabilizer treatment for BD, but only a minority of patients fully respond to monotherapy. Presently, we hypothesized that lithium-responsive BD patients (Li-R) would show characteristic differences in chronotype and cellular circadian rhythms compared to lithium non-responders (Li-NR). Selecting patients from a prospective, multi-center, clinical trial of lithium monotherapy, we examined morning vs. evening preference (chronotype) as a dimension of circadian rhythm function in 193 Li-R and Li-NR BD patients. From a subset of 59 patient donors, we measured circadian rhythms in skin fibroblasts longitudinally over 5 days using a bioluminescent reporter (Per2-luc). We then estimated circadian rhythm parameters (amplitude, period, phase) and the pharmacological effects of lithium on rhythms in cells from Li-R and Li-NR donors. Compared to Li-NRs, Li-Rs showed a difference in chronotype, with higher levels of morningness. Evening chronotype was associated with increased mood symptoms at baseline, including depression, mania, and insomnia. Cells from Li-Rs were more likely to exhibit a short circadian period, a linear relationship between period and phase, and period shortening effects of lithium. Common genetic variation in the IP 3 signaling pathway may account for some of the individual differences in the effects of lithium on cellular rhythms. We conclude that circadian rhythms may influence response to lithium in maintenance treatment of BD.

Soldiers with PTSD were at increased risk for suicidality, and, among those with PTSD, those with at least 2 additional conditions were at the highest risk of suicidal ideation. Future research should address the mechanisms that contribute to multimorbidity in this population and the appropriate treatment methods for this high-risk group.

This study investigates the relationship between psychological well-being and the impact of loss and psychological uncertainty after the 2000 Miyake Island volcanic eruption. 231 Japanese evacuees (ages 20-93, average 59.52 years old) responded to mailed questionnaires 10 months after the volcanic eruption in 2000. The questionnaire included the Impact of Event Scale-Revised (IES-R) for posttraumatic stress disorder, an 11-item version of the Center for Epidemiological Study-Depression Scale (CES-D), assessment of disaster losses, demographics, and measure of relevant pre-and post-disaster activities (e.g., relocation, worry, doctor visits). Findings indicated that material loss and uncertainty of losses were significantly associated with higher rates of reported PTSD and depression symptoms. Those who relocated multiple times reported significantly higher rates of PTSD symptoms than those who relocated less frequently. Demographic characteristics such as being older, widowed, lower SES, less education, and longer length of residency on the island were also strongly associated with higher reported PTSD symptoms. Depression symptoms were strongly associated with being widowed, lower SES, longer length of residency on the island, and previous experiences of evacuations due to disasters.

Based on available literature, this review article investigates traumatic stress studies in Japan from the late 19th century to the present for English speaking audiences. First, traumatic neuroses of war victims, A-bomb survivors, and victims of work-related accidents are discussed. Second, traumatic stress studies of victims of other manmade disasters, such as the sarin gas attacks in Tokyo, domestic violence, and burn injuries. Third, psychological outcomes of natural disaster studies are discussed in relation to social support and help-seeking tendencies of Japan disaster victims.

No abstract