The association between biological rhythms, depression, and functioning in bipolar disorder: a large multi‐center study
Abstract
Objective: We examined the relationship between biological rhythms and severity of depressive symptoms in subjects with bipolar disorder and the effects of biological rhythms alterations on functional impairment. Method: Bipolar patients (n = 260) and healthy controls (n = 191) were recruited from mood disorders programs in three sites (Spain, Brazil, and Canada). Parameters of biological rhythms were measured using the Biological Rhythms Assessment in Neuropsychiatry (BRIAN), an interviewer administered questionnaire that assesses disruptions in sleep, eating patterns, social rhythms, and general activity. Results: Multivariate analyses of covariance showed significant intergroup differences after controlling for potential confounders (Pillai's F = 49.367; df = 2, P < 0.001). Depressed patients had the greatest biological rhythms disturbance, followed by patients with subsyndromal symptoms, euthymic patients, and healthy controls. Biological rhythms and HAMD scores were independent predictors of poor functioning (F = 12.841, df = 6, P < 0.001, R2 = 0.443). Conclusion: Our study shows a dose‐dependent association between the severity of depressive symptoms and degree of biological rhythms disturbance. Biological rhythms disturbance was also an independent predictor of functional impairment. Although the directionality of this relationship remains unknown, our results suggest that stability of biological rhythms should be an important target of acute and long‐term management of bipolar disorder and may aid in the improvement of functioning.
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Normalizing and stabilizing circadian rhythms through lithium or other methods has proven an effective therapy for ameliorating episodes of depression and mania, and for preventing relapse into these states.
“The approach of normalizing and stabilizing circadian rhythms, through lithium or other methods, has proven an effective therapy for ameliorating episodes of depression and mania, and for preventing relapse into these states124,125.”
From Circadian rhythm disruption and mental health (2020) · cites this paper as [124]
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- Authors
- Pinho, M., Sehmbi, M., Cudney, L. E., Kauer‐Sant'anna, M., Magalhães, P. V., Reinares, M., Bonnín, C. M., Sassi, R. B., Kapczinski, F., Colom, F., Vieta, E., Frey, B. N., & Rosa, A. R.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- McMaster University (CA)
- St. Joseph’s Healthcare Hamilton (CA)
- Laboratory of Molecular Psychiatry INCT for Translational Medicine ‐ CNPq Hospital de Clínicas de Porto Alegre Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Bipolar Disorders Program Institute of Neurosciences Hospital Clinic University of Barcelona IDIBAPS Catalonia Spain
- Corresponding author
- Rosa, A. R
- ORCID
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2015-05-22
- Volume
- 133
- Issue
- 2
- Pages
- 102-108
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W1957005169
- Cited by
- 96
- References
- 43
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 8 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 14 · 2019: 7 · 2018: 9 · 2017: 12 · 2016: 17 · 2015: 3
- FWCI
- 11.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministerio de Economía y Competitividad
- Instituto de Salud Carlos III
- Centro de Investigación Biomédica en Red de Salud Mental
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- bipolar disorder, biological rhythms, circadian rhythm disruption, depressive symptoms, functional disability, social rhythms, sleep disruption, dietary habits, subsyndromal symptoms
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