The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.
Short communication: Do clinical guidelines for bipolar disorders adequately address sleep, circadian rhythm, activity and lifestyle problems?
Abstract
Objectives Clinical practice guidelines (CPGs) for the treatment of bipolar disorder (BD) provide guidance to health care professionals and patients about the management of core aspects of BD. This study evaluated the overall quality of CPGs and examined the quantity, specificity, clarity and utility of recommendations about four key contemporary themes: sleep, circadian rhythms, activity and energy, and healthy lifestyles. Methods English language editions of CPGs for the treatment of BD were identified by a systematic search of the literature from 2007 onwards (i.e. 15 years). Blind independent ratings were combined to give consensus scores for the quality of each CPGs (using the 14-item International Center for Allied Health Evidence guideline checklist). Composite ratings of the quantity, specificity, clarity and utility of recommendations about the key themes were undertaken using a 0-3 scale. Results Twenty-five CPGs were eligible for review. Overall quality was high (median checklist score=10), but only 11 (44%) CPGs included even basic information about circadian rhythm disturbances. Combined scores for composite ratings about sleep and circadian rhythms were significantly correlated with overall quality of the CPG (sleep, r = 0.43; circadian rhythms, r = 0.42) but not with year of publication. Limitations No reliable scale exists for generating composite ratings of the four themes we examined. Conclusions Circadian rhythms and chronobiology represent neglected domains in CPGs. Incorporating this important theme into future editions of CPGs would aid health care professionals to identify, prevent, or intervene with these problems and improve outcomes for a significant proportion of individuals with BD.
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Many Clinical Practice Guidelines and clinical training programs have not incorporated evidence on circadian dysfunction and chronotherapy into their recommendations and curricula.
“many Clinical Practice Guidelines and clinical training programs have not incorporated this evidence in their recommendations and curricula.”
From Essential Information About Chronobiology and Chronotherapy for the Optimal Care of People With Bipolar Disorders: An Expert Consensus (2026) · cites this paper as [25]
A review of 25 Clinical Practice Guidelines for bipolar disorders found that fewer than half included even a basic discussion of circadian disturbances.
“A review of 25 CPGs for BD found that fewer than half included even a basic discussion of circadian disturbances [25].”
From Essential Information About Chronobiology and Chronotherapy for the Optimal Care of People With Bipolar Disorders: An Expert Consensus (2026) · cites this paper as [25]
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“A review of 25 CPGs for BD found that fewer than half included even a basic discussion of circadian disturbances [25].”
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Metadata
- Authors
- Flint, T., Hennion, V., Etain, B., & Scott, J.
- Affiliations
- University of Bristol (GB)
- Inserm (FR)
- Université Paris Cité (FR)
- Corresponding author
- Scott, Jan
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 301
- Pages
- 433-436
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W4205192083
- Cited by
- 5
- References
- 20
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- bipolar disorder, guideline quality, sleep, circadian rhythm, chronobiology, physical activity, lifestyle, energy, guideline recommendations
- MeSH terms
- Bipolar Disorder, Circadian Rhythm, Health Personnel, Humans, Life Style, Sleep
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