Rest‐Activity Rhythms and Suicidal Ideation in Pediatric Bipolar Disorder

🎖️ Top 10% JournalJan 17, 2026Bipolar disorders

Daily Activity Patterns and Suicidal Thoughts in Children with Bipolar Disorder

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

In a sample of 54 youth with bipolar disorder, greater interdaily stability and higher average activity levels during wake were linked to lower severity.

Greater stability in daily activity patterns is associated with reduced severity of suicidal thoughts.
Higher levels of activity during waking hours correlate with lower levels of suicidal ideation.
These associations persist even after adjusting for factors like age, type of bipolar disorder, medication use, and depressive symptoms.

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INTRODUCTION: Risk for suicide is disproportionately elevated among youth with bipolar spectrum disorder (BD), which is characterized by recurrent mood episodes and significant shifts in sleep and circadian rhythm. Disruptions in circadian rhythm, such as 24-h rest-activity patterns, are a relevant risk factor for , yet understudied in BD youth. The present cross-sectional study examined the associations between actigraphy-derived (RARs) and self-reported suicidal ideation (SI) severity in a sample of 54 BD youth (aged 12-18 years).

METHOD: Participants completed daily wrist actigraphy (M = 18.89, range: 6 to 29 days) and non-parametric RAR measures were derived for analyses. At the same time, participants provided self-report data on depressive symptoms and SI severity (number of days between actigraphy start and questionnaire completion: M = -7.74, SD = 13.33, range: -46 to 28 days). Primary analyses examined associations between RAR variables and SI severity, controlling for several key covariates including age, BD subtype, psychotropic medication use, and depressive symptoms. days days

RESULTS: Results revealed that greater interdaily stability and higher average activity levels during wake were associated with lower SI severity. These results remained significant even when controlling for the aforementioned covariates.

CONCLUSION: Results indicated that greater and more consistent activity levels within and across days are associated with lower suicide risk. Findings suggest that RARs are relevant for suicide risk detection and intervention for BD youth.

Key numbers

86%

Decrease in Odds of Critical Items

Risk Ratio = 0.14 for endorsing critical items on the SIQ-JR.

54 participants

Sample Size

Final sample size after exclusions for actigraphy and self-report data.

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