Bipolar disorders: is there an influence of seasonality or photoperiod?

Aguglia, Andrea; Borsotti, Antonio; Maina, Giuseppe

doi:10.1590/1516-4446-2016-2144

Cited by 31 publications

(19 citation statements)

References 42 publications

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“…In line with our hypothesis, the first significant finding consisted in the increased amount of bipolar subjects’ admissions when the mean sunshine hours was longer. This result confirms the role of meteorological variables such as sunshine hours on the admission rates of bipolar subjects when using a different methodology rather that that used in previously published studies [14,16], suggesting that the photoperiod reaches its maximum extension during summer and its minimum during winter in Italy. Importantly, increased sunlight exposure during the day has been hypothesized to play a stabilizing effect on specific neurotransmitters levels such as monoamines that are relevant to mood disorders [6].…”

Section: Discussionsupporting

confidence: 84%

“…In healthy subjects, environmental variables such as sunlight exposure, photoperiod and solar radiation/insolation can regulate behavior affecting circadian functions and detemine changes of many biological rhythms. Recently, some authors investigated the role of these factors in bipolar patients with significant impact on both the onset and course of BD and consequently on sleep-wake cycle, mood and energy [10,12,13,14,15,16]. Furthermore, certain authors indicated that environmental factors, such as humidity, day length, ultraviolet radiation, temperature, rainfall/atmospheric pressure or airborne allergens exert a significant role on the admission of BD patients, particularly in (hypo)manic phase, or when they exhibit specific symptoms such as psychosis, impulsiveness, and suicidal behavior/aggression [14,17,18,19,20,21,22,23,24,25].…”

Section: Introductionmentioning

confidence: 99%

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Maximum Temperature and Solar Radiation as Predictors of Bipolar Patient Admission in an Emergency Psychiatric Ward

Aguglia

Serafini

Escelsior

et al. 2019

IJERPH

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Environmental variables can regulate behavior in healthy subjects. Recently, some authors investigated the role of meteorological variables in bipolar patients with an impact on both the onset and course of bipolar disorder (BD). The aim of this study was to investigate the impact of meteorological variables and other indexes in bipolar hospitalized patients. We examined all patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital, Orbassano (Turin, Italy) from September 2013 to August 2015, collecting several socio-demographic and clinical characteristics. Seven hundred and thirty patients were included. Compared to the day of admission of control individuals, patients with BD were admitted on a day that presented higher minimum, medium, and maximum temperature, higher maximum humidity, higher solar radiation, and higher hours of sunshine. After logistic regression analysis, admissions to the emergency psychiatric ward due to a primary diagnosis of BD were associated with maximum temperature and solar radiation. The current study provides a novel perspective on the question surrounding seasonal mood patterns in patients with BD. A greater awareness of all possible precipitating factors is needed to inform self-management and psycho-educational programs as well as to improve resilience regarding affective recurrences in the clinical practice.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Maximum Temperature and Solar Radiation as Predictors of Bipolar Patient Admission in an Emergency Psychiatric Ward

Aguglia

Serafini

Escelsior

et al. 2019

IJERPH

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“…In any case, given the very distinct timing of the spring peak in suicidal mixed mood states, one is tempted to attribute this heightened springtime conflict between polar opposite moods to some kind of pathological transitional state between winter and summer modes of mood and energy regulation (i.e., depression vs. mania). Relevant to this hypothesis of transitions from winter to spring is that many, but not all, studies have found summer peaks in the incidence of mania [reviewed in 65]. …”

Section: Discussionmentioning

confidence: 99%

Chris Cornell, the Black Hole Sun, and the Seasonality of Suicide

Schwartz¹

2019

Neuropsychobiology

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Purpose: Seattle-inspired rock and roll superstar Chris Cornell died by suicide in May 2017. In the northern hemisphere, May represents the peak of the widely replicated but still unexplained seasonal spring rhythm in suicide. Years earlier, Cornell had suffered openly from recurrent bouts of severe depression, and his early musical lyrics do indeed suggest an enduring sensitivity to the vicissitudes of depressed and suicidal states. Cornell’s most famous song, Black Hole Sun, suggests a mixed mood state, the incidence of which also peaks in the spring. The present work explores Cornell’s May suicide from a chronobiologic perspective. Methods: Review of Cornell’s lyrics and literature on suicide. Results: Cornell’s lyrics contain clear indicators of mixed depressive and seasonal imagery, highlighting 3 fundamental axioms of suicidology: (1) the yearly suicide rhythm peaks in May in the northern hemisphere, (2) mixed depressive states are particularly lethal, and (3) the suicide risk increases dramatically when recovering from depression and mood turns mixed. Conclusions: Cornell, in his life and music, left us with a novel and important hypothesis about the spring seasonality of suicide, namely, that the yearly suicide risk becomes maximal when winter turns to spring and there emerges a deadly mixed mood state under a May photoperiod, i.e., the suicide risk is maximal when a Black Hole Sun occurs in May. It is hoped that Cornell’s legacy and sensitive hypothesis inspire research into the etiology and treatment of the spring seasonality of suicide risk and mixed mood states. Limitations: The Cornell hypothesis was formulated based in part on several speculative inferences regarding the course of his functioning just prior to his suicide.

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“…If patients had more than one psychiatric diagnosis, the principal psychiatric condition as diagnosed by the treating psychiatrist, was recorded. According to previous published studies (33, 34), we grouped the diagnosis in four main categories: bipolar and related disorders, depressive disorders, schizophrenia, and related disorders, other psychiatric disorders.…”

Section: Methodsmentioning

confidence: 99%

The Association Between Dyslipidemia and Lethality of Suicide Attempts: A Case-Control Study

et al. 2019

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Evidence supports the existence of an association between dyslipidemia, psychiatric disorders, and suicide risk due to the effects of altered lipid profiles on serotoninergic neuron membranes. The aim of this study was to investigate the differences in c-reactive protein (CRP), thyroid functioning, total cholesterol, high lipoprotein density cholesterol (HDL-c), low-lipoprotein density cholesterol (LDL-c), and triglycerides (TG) serum levels in low lethality (LLSA) vs. high lethality suicide attempters (HLSA) within 24 h from the suicide attempt and inpatients who never attempted suicide (NAS). After attempting suicide, subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the section of Psychiatry from 1st August 2013 to 31st July 2018. Socio-demographic and clinical characteristics, serum lipids profile, CRP, and thyroid functioning were collected. The sample consisted of 133 individuals with a HLSA, 299 subjects with LLSA, and 200 patients NAS. HLSA subjects were more likely to be males and diagnosed as having a bipolar disorder. Furthermore, HLSA subgroup showed significantly lower total cholesterol and LDL-c levels and higher CRP serum levels compared to LLSA and control group, respectively. LLSA subgroup showed higher HDL-c levels compared to HLSA subgroup (no differences between HLSA and control group were observed). Additionally, the control group reported higher triglycerides levels compared to patients admitted to psychiatric ward for a suicide attempt. Only male gender, having a diagnosis of bipolar disorder, lower total cholesterol, and higher CRP serum levels predicted HLSA. Investigating the relation between dyslipidemia and the severity of suicide attempts may contribute to reveal the complex determinants underlying at-risk behaviors such as suicide, thus playing a relevant role in the possible prevention of this disabling phenomenon.

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Bipolar disorders: is there an influence of seasonality or photoperiod?

Cited by 31 publications

References 42 publications

Maximum Temperature and Solar Radiation as Predictors of Bipolar Patient Admission in an Emergency Psychiatric Ward

Maximum Temperature and Solar Radiation as Predictors of Bipolar Patient Admission in an Emergency Psychiatric Ward

Chris Cornell, the Black Hole Sun, and the Seasonality of Suicide

The Association Between Dyslipidemia and Lethality of Suicide Attempts: A Case-Control Study

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