Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders

Mar 22, 2017Current psychiatry reports

Disrupted Body Clock Patterns in Bipolar Disorders

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Abstract

Relative circadian phase delay is associated with bipolar spectrum disorders (BSDs), especially during depressive phases.

Circadian phase delay includes factors such as a later melatonin peak and evening chronotype.
Irregular social rhythms, sleep/wake patterns, and activity levels are stable trait markers of BSD.
Disruptions in social rhythms due to life events may indicate vulnerabilities for the onset of BSD.
Both internal biological clock abnormalities and external disruptions contribute to circadian dysregulation in BSDs.
Circadian dysregulation may increase the risk of developing BSD.

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PURPOSE OF REVIEW: We review recent evidence for circadian rhythm dysregulation in bipolar spectrum disorders (BSDs). We examine evidence for endogenous abnormalities in the biological clock and disruptions in the external entrainment of circadian rhythms in BSDs. We also address whether circadian dysregulation provides vulnerability to onset of BSD and evidence for a new integration of reward and circadian dysregulation in BSD.

RECENT FINDINGS: Relative circadian phase delay (e.g., later melatonin peak, evening chronotype) is associated with BSD, particularly in the depressive phase. More consistent evidence supports irregularity of social rhythms, sleep/wake and activity patterns, and disruptions of social rhythms by life events, as stable trait markers of BSD and potential vulnerabilities for BSD onset. Growing research supports an integrative reward/circadian model. Both endogenous abnormalities in the biological clock pacemaking function and disruptions in the external entrainment of circadian rhythms by physical and social cues are involved in BSDs. Circadian dysregulation may provide vulnerability to BSD onset.

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Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders

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