Seasonality and bipolar disorder: A systematic review, from admission rates to seasonality of symptoms
Open accessAbstract
Introduction Bipolar disorder (BD) is a severe mental disorder affecting 1-4% of the population worldwide. It is characterized by periods of (hypo)manic and depressive episodes. Seasonal patterns (SP) may be observed in admission rates, mood relapses and symptom fluctuations. Methods We conducted a systematic review of seasonality in BD, classifying studies based on seasonal admission rates to seasonality of symptoms assessments. Results Fifty-one papers were identified of which 32 addressed hospitalization rates by season, 6 addressed categorical diagnoses, and 13 explored symptom dimensions. Seasonal peaks for different BD mood episodes are observed worldwide and widely replicated. Manic episodes peak during spring/summer and, to a lesser extent, in autumn, depressive episodes peak in early winter and, to a lesser extent, summer, and mixed episodes peak in early spring or mid/late summer. There was a high frequency of SP for manic episodes (15%) and depressive episodes (25%), the latter being associated with a more complex clinical profile (BD II subtype, comorbid eating disorders, more relapses and rapid cycling). Finally, there was evidence for greater seasonal fluctuations in mood and behavior in individuals with BD than in those with unipolar depression or 'healthy' controls. Limitations Sample size, gender distribution, methodological quality and sophistication of the analytical approaches employed varied considerably. Conclusions There is evidence of seasonality in BD, with emerging evidence that climatic conditions may trigger BD symptoms or episodes. A better understanding of the underlying mechanisms would facilitate the development of personalized chronobiological therapeutic and preventive strategies.
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Bipolar disorder shows seasonal fluctuations in mood and behavior.
“Bipolar disorder showed seasonal fluctuations in mood and behavior (Geoffroy et al., 2014).”
From Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials (2020) · cites this paper as Geoffroy et al., 2014
There is a significant antidepressant effect of dawn simulation for seasonal affective disorder.
“Meta‐analyses studies revealed that there is a significant antidepressant effect in dawn simulation for seasonal affective disorder (Geoffroy et al., 2014).”
From Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials (2020) · cites this paper as Geoffroy et al., 2014
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575 · see citing works
Wu, J. C., Kelsoe, J. R., Schachat, C., Bunney, B. G., DeModena, A., Golshan, S., Gillin, J. C., Potkin, S. G., & Bunney, W. E. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.02.018 · Cited by 263 · see citing works
Benedetti, F., Barbini, B., Fulgosi, M. C., Colombo, C., Dallaspezia, S., Pontiggia, A., & Smeraldi, E. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n1207 · Cited by 180 · see citing works
Help-Seeking Behaviours of Individuals with Mood Disorders
Wang, J., Patten, S. B., Williams, J. V., Currie, S., Beck, C. A., Maxwell, C. J., & El-Guebaly, N. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001012 · Cited by 79 · see citing works
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Gottlieb, J. F., Benedetti, F., Geoffroy, P. A., Henriksen, T. E. G., Lam, R. W., Murray, G., Phelps, J., Sit, D., Swartz, H. A., Crowe, M., et al. (2019) · Bipolar Disorders · doi:10.1111/bdi.12847 · Cited by 196 · see citing works
Self-citationCho, C.-H., Lee, T., Kim, M.-G., In, H. P., Kim, L., & Lee, H.-J. (2019) · Journal of Medical Internet Research · doi:10.2196/11029 · Cited by 183 · see citing works
Blue‐blocking glasses as additive treatment for mania: a randomized placebo‐controlled trial
Henriksen, T. E., Skrede, S., Fasmer, O. B., Schoeyen, H., Leskauskaite, I., Bjørke‐Bertheussen, J., Assmus, J., Hamre, B., Grønli, J., & Lund, A. (2016) · Bipolar Disorders · doi:10.1111/bdi.12390 · Cited by 139 · see citing works
Circadian depression: A mood disorder phenotype
Carpenter, J. S., Crouse, J. J., Scott, E. M., Naismith, S. L., Wilson, C., Scott, J., Merikangas, K. R., & Hickie, I. B. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.02.045 · Cited by 114 · see citing works
Self-citationBright light as a personalized precision treatment of mood disorders
Maruani, J., & Geoffroy, P. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00085 · Cited by 112 · see citing works
Self-citationHirakawa, H., Terao, T., Muronaga, M., & Ishii, N. (2020) · Brain and Behavior · doi:10.1002/brb3.1876 · Cited by 61 · see citing works
Medici, C. R., Vestergaard, C. H., Hadzi-Pavlovic, D., Munk-Jørgensen, P., & Parker, G. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.06.053 · Cited by 56 · see citing works
Efficacy of bright light therapy in bipolar depression
Yorguner Kupeli, N., Bulut, N. S., Carkaxhiu Bulut, G., Kurt, E., & Kora, K. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.12.020 · Cited by 51 · see citing works
Photoperiodic and circadian bifurcation theories of depression and mania
Kripke, D. F., Elliott, J. A., Welsh, D. K., & Youngstedt, S. D. (2015) · F1000Research · doi:10.12688/f1000research.6444.1 · Cited by 48 · see citing works
Yalçın, M., Baş, A., Bilici, R., Özdemir, Y. Ö., Beştepe, E. E., Kurnaz, S., Güneş, M., Kurt, V., & Koyu, E. (2021) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-021-02171-0 · Cited by 36 · see citing works
Li, X., Chen, B., Zhang, D., Wang, S., Feng, Y., Wu, X., Cui, L., Ji, M., Gong, W., Verkhratsky, A., et al. (2023) · Molecular Psychiatry · doi:10.1038/s41380-023-02037-8 · Cited by 27 · see citing works
Light treatment in depression: An antique treatment with new insights
Geoffroy, P. A., Schroder, C. M., & Bourgin, P. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2018.03.002 · Cited by 22 · see citing works
Self-citationHaimovich, J. S., Venkatesh, A. K., Shojaee, A., Coppi, A., Warner, F., Li, S.-X., & Krumholz, H. M. (2017) · PLOS ONE · doi:10.1371/journal.pone.0172049 · Cited by 15 · see citing works
Association between polarity of first episode and solar insolation in bipolar I disorder
Bauer, M., Glenn, T., Achtyes, E. D., Alda, M., Agaoglu, E., Altınbaş, K., Andreassen, O. A., Angelopoulos, E., Ardau, R., Aydin, M., et al. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110982 · Cited by 14 · see citing works
Self-citationSeasonal affective disorder and non-seasonal affective disorders: Results from the NESDA study
Winthorst, W. H., Roest, A. M., Bos, E. H., Meesters, Y., Penninx, B. W. J. H., Nolen, W. A., & de Jonge, P. (2017) · BJPsych Open · doi:10.1192/bjpo.bp.116.004960 · Cited by 13 · see citing works
- Authors
- Geoffroy, P. A., Bellivier, F., Scott, J., & Etain, B.
- Affiliations
- Inserm (FR)
- Newcastle University (GB)
- Corresponding author
- Geoffroy, Pierre Alexis
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 168
- Pages
- 210-223
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2163046703
- Cited by
- 251
- References
- 4
- Citations by year
- 2026: 24 · 2025: 24 · 2024: 25 · 2023: 23 · 2022: 31 · 2021: 22 · 2020: 22 · 2019: 15 · 2018: 12 · 2017: 22 · 2016: 16 · 2015: 13 · 2014: 1
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Sanofi
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- bipolar disorder, seasonal variation, seasonal patterns, manic episodes, depressive episodes, mixed states, hospitalization rates, rapid cycling, eating disorder comorbidity, chronobiology
- MeSH terms
- Affect, Bipolar Disorder, Depressive Disorder, Major, Major Depressive Disorder, Female, Hospitalization, Humans, Patient Admission, Recurrence, Seasons
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