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Circadian rhythm disturbances in mood disorders: characterisation and clinical impact

Published online by Cambridge University Press:  19 July 2023

G. Cappannini*
Affiliation:
1Department of Psychiatry
S. Bianchi
Affiliation:
1Department of Psychiatry
G. Menculini
Affiliation:
1Department of Psychiatry
B. Semeraro
Affiliation:
2School of Medicine, University of Perugia
F. De Giorgi
Affiliation:
3Section of Psychiatry, Clinical Psychology and Rehabilitation, Santa Maria Della Misericordia Hospital
K. Amantini
Affiliation:
4Psichiatric Inpatient Unit Department of Mental Health, AUSL Umbria 1, Perugia, Italy
P. Moretti
Affiliation:
1Department of Psychiatry
A. A. V. Tortorella
Affiliation:
1Department of Psychiatry
*
*Corresponding author.

Abstract

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Introduction

Circadian rhythms, defined as endogenous oscillations that regulate metabolism, physiology and behaviour, may be frequently disrupted in mood disorders, influencing their clinical presentation and course (Srinivasan V. et al. World J Biol Psychiatry. 2006;7(3):138-151).

Objectives

To characterise circadian rhythm disruptions in a population of patients with mood disorders, analysing clinical and course differences in subjects with and without clinically significant circadian rhythm alterations

Methods

Patients selected for this cross-sectional study were assessed with CGI-BP, HAM-D, MRS, and PANSS. Circadian rhythm disturbances were evaluated with BRIAN. Patients with clinically relevant circadian rhythm disturbances were defined as BRIAN > 36 (Mondin TC et al. J Psychiatr Res. 2017;84:98-104). Bivariate analyses were subsequently performed to compare subgroups of patients.

Results

In our study, 61 subjects with DD or DB were enrolled. The overall mean BRIAN test score was 40.08 ± 10.26. When comparing the BRIAN test scores, both total and subscales, between subjects with DB and DD, social rhythms were significantly more altered in subjects with DB (8.63 ± 2.90 VS 6.80 ± 2.11, p=0.034). Subjects with disruption of circadian rhythms displayed greater severity of depressive symptoms (mean total HAM-D test score 16.06±8.61 VS 8.94±5.85; p<0.003, mean CGI-BP severity of depression test score 3.14±1.68 VS 1.88±1.11; p<0.010) and with a longer duration of untreated illness (6.14±8.64 VS 2.53±6.28; p= 0.040).

Conclusions

Alterations in circadian rhythms should be routinely investigated in all individuals with mood disorders, especially BD, and may represent a transdiagnostic psychopathological construct that defines a more severe disease phenotype.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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