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Review
. 2017 Apr;19(4):21.
doi: 10.1007/s11920-017-0772-z.

Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders

Lauren B Alloy  1 , Tommy H Ng  2 , Madison K Titone  2 , Elaine M Boland  3
Affiliations
Review

Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders

Lauren B Alloy et al. Curr Psychiatry Rep. 2017 Apr.

Abstract

Purpose of review: We review recent evidence for circadian rhythm dysregulation in bipolar spectrum disorders (BSDs). We examine evidence for endogenous abnormalities in the biological clock and disruptions in the external entrainment of circadian rhythms in BSDs. We also address whether circadian dysregulation provides vulnerability to onset of BSD and evidence for a new integration of reward and circadian dysregulation in BSD.

Recent findings: Relative circadian phase delay (e.g., later melatonin peak, evening chronotype) is associated with BSD, particularly in the depressive phase. More consistent evidence supports irregularity of social rhythms, sleep/wake and activity patterns, and disruptions of social rhythms by life events, as stable trait markers of BSD and potential vulnerabilities for BSD onset. Growing research supports an integrative reward/circadian model. Both endogenous abnormalities in the biological clock pacemaking function and disruptions in the external entrainment of circadian rhythms by physical and social cues are involved in BSDs. Circadian dysregulation may provide vulnerability to BSD onset.

Keywords: bipolar spectrum disorders; chronotype; circadian rhythms; melatonin; social rhythms; zeitgeber.

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Figures

Figure 1.
Figure 1.
Dual pathways to circadian dysregulation in symptoms of bipolar spectrum disorders.
See this image and copyright information in PMC

References

    1. Alloy LB, Urošević S, Abramson LY, Jager-Hyman S, Nusslock R, et al. Progression along the bipolar spectrum: A longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders. J. Abnorm. Psychol 2012b;121:16–27. - PMC - PubMed
    1. Birmaher B, Axelson D, Goldstein B, Strober M, Gill MK, et al. Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: The course and outcome of bipolar youth (COBY) study. Am. J. Psychiatry 2009;166:795–804. - PMC - PubMed
    1. Akiskal HS, Djenderedjian AH, Rosenthal RH, Khani MK. Cyclothymic disorder: Validating criteria for inclusion in the bipolar affective group. Am J Psychiatry. 1977;134:1227–33. - PubMed
    1. Kochman FJ, Hantouche EG, Ferrari P, Lancrenon S, Bayart D, Akiskal HS. Cyclothymic temperament as a prospective predictor of bipolarity and suicidality in children and adolescents with major depressive disorder. J. Affec. Disord 2005;85:181–9. - PubMed
    1. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RMA, et al. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey Replication. Arch. Gen. Psychiatry 2007;64:543–52. - PMC - PubMed

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