Chronobiology of Bipolar Disorder: Therapeutic Implication

Dallaspezia, Sara; Benedetti, Francesco

doi:10.1007/s11920-015-0606-9

Cited by 43 publications

(39 citation statements)

References 134 publications

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“…Clinical trials of IPSRT indicate that increasing regularization is associated with a preventative impact on mood episode recurrence in patients with bipolar I disorder (Frank et al, 2005). There are also medications and other chronotherapies shown to be highly effective in regulating circadian rhythms (Dallaspezia and Benedetti, 2015), possibly resulting in less variable sleep durations. It is possible that a moving average of variability obtained through unobtrusive self-monitoring devices could inform or enhance such therapies.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder

Kaufmann

Gershon

Eyler

et al. 2016

Journal of Psychiatric Research

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OBJECTIVE Sleep disturbances are prevalent, persistent, and impairing features of bipolar disorder. However, the near-term and cumulative impact of the severity and variability of sleep disturbances on symptoms and functioning remains unclear. We examined self-reported daily sleep duration and variability in relation to mood symptoms, medication adherence, cognitive functioning, and concurrent daily affect. METHODS Forty-one outpatients diagnosed with bipolar disorder were asked to provide daily reports of sleep duration and affect collected via ecological momentary assessment with smartphones over eleven weeks. Measures of depressive and manic symptoms, medication adherence, and cognitive function were collected at baseline and concurrent assessment of affect were collected daily. Analyses examined whether sleep duration or variability were associated with baseline measures and changes in same-day or next-day affect. RESULTS Greater sleep duration variability (but not average sleep duration) was associated with greater depressive and manic symptom severity, and lower medication adherence at baseline, and with lower and more variable ratings of positive affect and higher ratings of negative affect. Sleep durations shorter than 7-8 hours were associated with lower same-day ratings of positive and higher same-day ratings of negative affect, however this did not extend to next-day affect. CONCLUSIONS Greater cumulative day-to-day sleep duration variability, but not average sleep duration, was related to more severe mood symptoms, lower self-reported medication adherence and higher levels of negative affect. Bouts of short- or long-duration sleep had transient impact on affect. Day-to-day sleep variability may be important to incorporate into clinical assessment of sleep disturbances in bipolar disorder.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder

Kaufmann

Gershon

Eyler

et al. 2016

Journal of Psychiatric Research

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“…A number of studies have demonstrated that biological rhythm disturbances play an etiological role in bipolar disorder (BD) and that their regulation may contribute to a therapeutic effect [1,2]. Such disturbances can be detected not only during acute episodes of the illness but also in remission periods.…”

Section: Introductionmentioning

confidence: 99%

A Study of Biological Rhythm Disturbances in Polish Remitted Bipolar Patients using the BRIAN, CSM, and SWPAQ Scales

Dopierała¹,

Chrobak

Kapczinski

et al. 2016

Neuropsychobiology

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Background/Aims: The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) is a novel tool allowing for a complex assessment of biological rhythms. We compared patients with bipolar disorder (BD) and healthy control subjects (HC) using the Polish version of the BRIAN scale. Method: Fifty-four remitted BD patients (17 males and 37 females aged 52 ± 13 years) and 54 healthy control subjects (25 males and 29 females aged 42 ± 14 years) were studied. In addition to the BRIAN scale, the Composite Scale of Morningness (CSM) and the Sleep-Wake Pattern Assessment Questionnaire (SWPAQ) were employed. Results: The Polish version of the BRIAN scale displayed high feasibility and consistency, showing that the patients had greater biological rhythm disturbances than the controls. After regression analysis, significant differences were obtained for the BRIAN subscales activity and predominant chronotype, and for the SWPAQ items quality of night-time sleep and ability to stay awake. We obtained positive correlations between higher BRIAN scores and morningness and eveningness, but the correlations with vigilance and the ability to stay awake (on the SWPAQ) were negative. Conclusions: Using the BRIAN scale, we confirmed the greater disturbances of biological rhythm in Polish remitted bipolar patients, compared with healthy controls. The differences between these 2 groups in sleep-awake patterns were also demonstrated by the SWPAQ scores. In contrast to other studies, we were unable to confirm an evening chronotype as a discriminating factor between remitted bipolar patients and healthy subjects. This can be explained by the older age and the use of lithium by a significant proportion of the patients.

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“…1 Impairments in sleep-wake patterns have been reported in patients with BD, who are also more likely to have the evening chronotype than control subjects. 2,3 Brazilian investigators introduced the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) as a novel tool that allows complex assessment of biological rhythms 4 and showed that disruption in biological rhythms was greater in patients with BD than in those with major depression, and greater in both mood disorders than in community controls.…”

Section: Introductionmentioning

confidence: 99%

The Biological Rhythms Interview of Assessment in Neuropsychiatry in patients with bipolar disorder: correlation with affective temperaments and schizotypy

Dopierała

Chrobak

Kapczinski

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: To assess the relationship of biological rhythms, evaluated by the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), with affective temperaments and schizotypy. Methods: The BRIAN assessment, along with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) and the Oxford-Liverpool Inventory for Feelings and Experiences (O-LIFE), was administered to 54 patients with remitted bipolar disorder (BD) and 54 healthy control (HC) subjects. Results: The TEMPS-A cyclothymic temperament correlated positively and the hyperthymic temperament correlated negatively with BRIAN scores in both the BD and HC groups, although the correlation was stronger in BD subjects. Depressive temperament was associated with BRIAN scores in BD but not in HC; conversely, the irritable temperament was associated with BRIAN scores in HC, but not in BD. Several positive correlations between BRIAN scores and the schizotypal dimensions of the O-LIFE were observed in both BD and HC subjects, especially with cognitive disorganization and less so with unusual experiences and impulsive nonconformity. A correlation with introversion/ anhedonia was found only in BD subjects. Conclusion: Cyclothymic and depressive temperaments predispose to disturbances of biological rhythms in BD, while a hyperthymic temperament can be protective. Similar predispositions were also found for all schizotypal dimensions, mostly for cognitive disorganization.

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Chronobiology of Bipolar Disorder: Therapeutic Implication

Cited by 43 publications

References 134 publications

Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder

Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder

A Study of Biological Rhythm Disturbances in Polish Remitted Bipolar Patients using the BRIAN, CSM, and SWPAQ Scales

The Biological Rhythms Interview of Assessment in Neuropsychiatry in patients with bipolar disorder: correlation with affective temperaments and schizotypy

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