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Circadian rhythm dysfunction in bipolar affective disorder

Published online by Cambridge University Press:  13 August 2021

M.T. Valadas  and
R. Mota Freitas
M.T. Valadas*
Affiliation:
Serviço De Psiquiatria, Unidade Local de Saúde do Baixo Alentejo, Beja, Portugal
R. Mota Freitas
Affiliation:
Departamento De Psiquiatria E Saúde Mental, Hospital do Espírito Santo de Évora, Évora, Portugal
*
*Corresponding author.

Abstract

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Introduction

Sleep is paramount in bipolar affective disorder and sleep disturbance can be a trigger or initial manifestation of an episode of illness. Changes in the circadian rhythm in bipolar affective disorder have consistently been recognized and reported, however, this feature can be overlooked in daily clinical practice.

Objectives

We aim to review and summarize the literature regarding changes in circadian rhythm in patients with bipolar affective disorder.

Methods

We performed an updated review in the PubMed database using the terms “circadian rhythm” and “bipolar affective disorder”.

Results

Irregularity of the sleep–wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes, and the irregularity of social time cues are circadian rhythm markers disrupted in bipolar affective disorder. Circadian rhythm dysfunction might be a trait marker of this illness and can act as a predictor for the first onset of bipolar affective disorder and the relapse of mood episodes. Achieving normalization of circadian rhythm in combination with pharmacological, psychosocial and chronobiological treatments can be a tool for managing bipolar affective disorder.

Conclusions

Recognizing patterns of changes in circadian rhythms is important to detect and diagnose bipolar disorder in clinical practice, also affecting treatment. These alterations are often overlooked and can lead to inadequate treatment and management.

Keywords

bipolar affective disorderCircadian rhythm
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S196 - S197
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 (http://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), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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