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. 2024 Oct:340:116123.
doi: 10.1016/j.psychres.2024.116123. Epub 2024 Aug 10.

Bipolar disorder is characterized by chronotype instability: A longitudinal investigation of circadian typology and mood

Sarah H Sperry  1 , Elaine M Boland  2 , Helen J Burgess  3 , Robert Gonzalez  4 , Suzanne Gonzalez  5 , Jacqueline M Lane  6 , Michael J McCarthy  7 , Melvin G McInnis  3 , Anastasia K Yocum  3 , Margo W Menkes  3 , Philip R Gehrman  2
Affiliations

Bipolar disorder is characterized by chronotype instability: A longitudinal investigation of circadian typology and mood

Sarah H Sperry et al. Psychiatry Res. 2024 Oct.

Abstract

Background: Chronotype is associated with circadian rhythmicity, a core etiological factor underlying bipolar disorder (BD). Given converging evidence linking late chronotype with poor mental health, the goal of the present study was to examine chronotype (in)stability and its relation to mood symptoms over time.

Methods: Participants with BD I (n = 271), BD II (n = 88), and healthy controls (n = 217) were included (follow-upM=10 years, Range=5-15) from the Prechter Longitudinal Study. Chronotype category and midpoint of sleep, corrected for weekend sleep-debt (MSFsc), were measured with the Munich Chronotype Questionnaire administered every 12 months alongside clinician-rated mood and medication usage. Self-reported mood was measured bi-monthly. Mixed effects models tested whether mood was associated with (in)stability of chronotype category and MSFsc covarying for age, sex, age, and medication.

Results: Compared to HC, individuals with BD self-reported having a later chronotype that significantly fluctuated over time. Individuals with BDI showed significantly less stability in MSFsc than HC. Anticonvulsant use was associated with more stability in MSFsc whereas antidepressant use was associated with less stability in MSFsc.

Conclusions: In a large longitudinal cohort, individuals with BD displayed significant instability in circadian typology. Psychopharmacology in BD may have differential impacts on circadian timing that is important to monitor.

Keywords: Bipolar; Chronotype; Circadian; Depression; Longitudinal; Mania; Sleep.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Melvin G. McInnis reports financial support was provided by Prechter Family Charitable Fund. Melvin G. McInnis reports financial support was provided by The Richard Tam Foundation. Sarah H. Sperry reports financial support was provided by National Institute of Mental Health. Michael J. McCarthy reports a relationship with Alkermes Inc that includes: consulting or advisory. Philip R. Gehrman reports a relationship with Idorsia Pharmaceuticals Ltd that includes: consulting or advisory. Philip R. Gehrman reports a relationship with Fisher Wallace Laboratories that includes: consulting or advisory. Philip R. Gehrman reports a relationship with Merck & Co Inc that includes: funding grants. Philip R. Gehrman reports a relationship with Jazz Pharmaceuticals Inc that includes: funding grants. Helen J. Burgess reports a relationship with Natrol Inc that includes: board membership. Helen J. Burgess reports a relationship with F Hoffmann-La Roche Ltd that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.