Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder

Joung Ho Moon, Chul Hyun Cho, Gi Hoon Son, Dongho Geum, Sooyoung Chung, Hyun Kim, Seung Gul Kang, Young Min Park, Ho Kyoung Yoon, Leen Kim, Hee Jung Jee, Hyonggin An, Daniel F. Kripke, Heon Jeong Lee

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD). Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~ 7 hour advanced (equivalent to ~ 17 hour delayed). Phases of 21 out of these 23 cases returned to normal by ~ 7 hour delay along with treatment, but two out of 23 cases returned to normal by ~ 17 hour advance. In three cases of mixed manic episodes, the phases were ~ 6–7 hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~ 4–5 hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD.

Original languageEnglish
Pages (from-to)285-295
Number of pages11
JournalEBioMedicine
Volume11
DOIs
Publication statusPublished - 2016 Sep 1

Keywords

  • Bipolar disorders
  • Circadian dysregulation
  • Circadian rhythm
  • Phase shift

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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