title: Influence of light exposure during early life on the age of onset of bipolar disorder.
abstract: BACKGROUND
  Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association.
  
  
  METHODS
  Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4 N and 70.7 N, and 1.2 S and 41.3 S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation.
  
  
  RESULTS
  More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model.
  
  
  CONCLUSIONS
  Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany. Electronic address: michael.bauer@uniklinikum-dresden.de.
authors: Michael
authors: M
authors: Bauer
authors: ChronoRecord Association, Fullerton, CA, USA.
authors: Tasha
authors: T
authors: Glenn
authors: Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
authors: Martin
authors: M
authors: Alda
authors: NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, Oslo, Norway.
authors: Ole A
authors: OA
authors: Andreassen
authors: Department of Psychiatry, University of Athens Medical School, Eginition Hospital, Athens, Greece.
authors: Elias
authors: E
authors: Angelopoulos
authors: Unit of Clinical Pharmacology, University-Hospital of Cagliari, Italy.
authors: Raffaella
authors: R
authors: Ardau
authors: Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany.
authors: Christopher
authors: C
authors: Baethge
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
authors: Rita
authors: R
authors: Bauer
authors: Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia.
authors: Bernhard T
authors: BT
authors: Baune
authors: Psychiatrie, GH Saint-Louis - Lariboisière - F. Widal, AP-HP, INSERM UMR-S1144, Faculté de Médecine, Université D. Diderot, Paris, France; Fondation FondaMental, Créteil, France.
authors: Frank
authors: F
authors: Bellivier
authors: Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva Mental Health Center, Beer Sheva, Israel.
authors: Robert H
authors: RH
authors: Belmaker
authors: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria 3220, Australia; Department of Psychiatry, ORYGEN Youth Health Research Centre, Centre for Youth Mental Health and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia.
authors: Michael
authors: M
authors: Berk
authors: NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, Oslo, Norway.
authors: Thomas D
authors: TD
authors: Bjella
authors: Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy.
authors: Letizia
authors: L
authors: Bossini
authors: Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva Mental Health Center, Beer Sheva, Israel.
authors: Yuly
authors: Y
authors: Bersudsky
authors: Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong.
authors: Eric Yat
authors: EY
authors: Wo Cheung
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
authors: Jörn
authors: J
authors: Conell
authors: Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy.
authors: Maria
authors: M
authors: Del Zompo
authors: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria 3220, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria 3052, Australia.
authors: Seetal
authors: S
authors: Dodd
authors: AP-HP, Hôpitaux Universitaires Henri-Mondor, INSERM U955 (IMRB), Université Paris Est, Créteil, France; Fondation FondaMental, Créteil, France.
authors: Bruno
authors: B
authors: Etain
authors: Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy.
authors: Andrea
authors: A
authors: Fagiolini
authors: Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA.
authors: Mark A
authors: MA
authors: Frye
authors: 3rd Department of Psychiatry, Division of Neurosciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors: Kostas N
authors: KN
authors: Fountoulakis
authors: Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA.
authors: Jade
authors: J
authors: Garneau-Fournier
authors: Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain.
authors: Ana
authors: A
authors: Gonzalez-Pinto
authors: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors: John F
authors: JF
authors: Gottlieb
authors: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan.
authors: Hirohiko
authors: H
authors: Harima
authors: Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors: Stefanie
authors: S
authors: Hassel
authors: AP-HP, Hôpitaux Universitaires Henri-Mondor, INSERM U955 (IMRB), Université Paris Est, Créteil, France; Fondation FondaMental, Créteil, France.
authors: Chantal
authors: C
authors: Henry
authors: 3rd Department of Psychiatry, Division of Neurosciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors: Apostolos
authors: A
authors: Iacovides
authors: Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
authors: Erkki T
authors: ET
authors: Isometsä
authors: Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors: Flávio
authors: F
authors: Kapczinski
authors: Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
authors: Sebastian
authors: S
authors: Kliwicki
authors: BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria.
authors: Barbara
authors: B
authors: König
authors: Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Denmark.
authors: Rikke
authors: R
authors: Krogh
authors: Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors: Mauricio
authors: M
authors: Kunz
authors: Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
authors: Beny
authors: B
authors: Lafer
authors: Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Denmark.
authors: Erik R
authors: ER
authors: Larsen
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
authors: Ute
authors: U
authors: Lewitzka
authors: Mood Disorders Program, Fundacion San Vicente de Paul, Department of Psychiatry, Universidad de Antioquia, Medellín, Colombia.
authors: Carlos
authors: C
authors: Lopez-Jaramillo
authors: Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
authors: Glenda
authors: G
authors: MacQueen
authors: Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
authors: Mirko
authors: M
authors: Manchia
authors: Department of Psychiatry, University of Massachusetts, Worcester, MA, USA.
authors: Wendy
authors: W
authors: Marsh
authors: Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain.
authors: Mónica
authors: M
authors: Martinez-Cengotitabengoa
authors: NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, Oslo, Norway.
authors: Ingrid
authors: I
authors: Melle
authors: Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA.
authors: Scott
authors: S
authors: Monteith
authors: Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Research and Development, Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors: Gunnar
authors: G
authors: Morken
authors: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors: Rodrigo
authors: R
authors: Munoz
authors: Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
authors: Fabiano G
authors: FG
authors: Nery
authors: Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
authors: Claire
authors: C
authors: O'Donovan
authors: Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva Mental Health Center, Beer Sheva, Israel.
authors: Yamima
authors: Y
authors: Osher
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
authors: Andrea
authors: A
authors: Pfennig
authors: Deparment of Psychiatry, Diego Portales University, Santiago, Chile.
authors: Danilo
authors: D
authors: Quiroz
authors: UCT/MRC Human Genetics Research Unit, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
authors: Raj
authors: R
authors: Ramesar
authors: Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA.
authors: Natalie
authors: N
authors: Rasgon
authors: Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe-University Frankfurt am Main, Germany.
authors: Andreas
authors: A
authors: Reif
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
authors: Philipp
authors: P
authors: Ritter
authors: Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
authors: Janusz K
authors: JK
authors: Rybakowski
authors: Department of Psychiatry, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA.
authors: Kemal
authors: K
authors: Sagduyu
authors: Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil.
authors: Ângela
authors: Â
authors: Miranda-Scippa
authors: Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
authors: Emanuel
authors: E
authors: Severus
authors: BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria.
authors: Christian
authors: C
authors: Simhandl
authors: Department of Psychiatry, University of Cape Town, Cape Town, South Africa.
authors: Dan J
authors: DJ
authors: Stein
authors: Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina.
authors: Sergio
authors: S
authors: Strejilevich
authors: Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors: Ahmad Hatim
authors: AH
authors: Sulaiman
authors: City of Helsinki, Department of Social Services and Health Care, Psychiatry, Helsinki, Finland.
authors: Kirsi
authors: K
authors: Suominen
authors: Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan.
authors: Hiromi
authors: H
authors: Tagata
authors: Schizophrenia & Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Seatagaya, Tokyo, Japan.
authors: Yoshitaka
authors: Y
authors: Tatebayashi
authors: Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors: Carla
authors: C
authors: Torrent
authors: Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
authors: Eduard
authors: E
authors: Vieta
authors: Department of Psychiatry, NIMHANS, Bangalore 560029, India.
authors: Biju
authors: B
authors: Viswanath
authors: Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA.
authors: Mihir J
authors: MJ
authors: Wanchoo
authors: Department of Psychology, Chapman University, Orange, CA, USA.
authors: Mark
authors: M
authors: Zetin
authors: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles (UCLA), Los Angeles, CA, USA.
authors: Peter C
authors: PC
authors: Whybrow
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000453:epidemiology*; D002980:Climate; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D012621:Seasons
keywords: Age of onset; Bipolar disorder; Hours of daylight; Insolation; Sunlight