title: Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder.
abstract: Disturbances in circadian rhythms have been suggested as a possible cause of bipolar disorder (BD). Included in this study were 31 mood episodes of 26 BD patients, and 18 controls. Circadian rhythms of BD were evaluated at admission, at 2-week intervals during hospitalization, and at discharge. All participants wore wrist actigraphs during the studies. Saliva and buccal cells were obtained at 8:00, 11:00, 15:00, 19:00, and 23:00 for two consecutive days. Collected saliva and buccal cells were used for analysis of the cortisol and gene circadian rhythm, respectively. Circadian rhythms had different phases during acute mood episodes of BD compared to recovered states. In 23 acute manic episodes, circadian phases were ~7hour advanced (equivalent to ~17hour delayed). Phases of 21 out of these 23 cases returned to normal by ~7hour delay along with treatment, but two out of 23 cases returned to normal by ~17hour advance. In three cases of mixed manic episodes, the phases were ~6-7hour delayed. For five cases of depressive episodes, circadian rhythms phases were ~4-5hour delayed. After treatment, circadian phases resembled those of healthy controls. Circadian misalignment due to circadian rhythm phase shifts might be a pathophysiological mechanism of BD.
authors.affiliation: Dept. of Psychiatry, Korea Univ. College of Medicine, Seoul, South Korea; Dept. of Biomedical Sciences, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Moon
authors.affiliation: Dept. of Psychiatry, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Cho
authors.affiliation: Dept. of Legal Medicine, Korea Univ. College of Medicine, South Korea.
authors.forename: Gi Hoon
authors.initials: GH
authors.lastname: Son
authors.affiliation: Dept. of Biomedical Sciences, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Dongho
authors.initials: D
authors.lastname: Geum
authors.affiliation: Dept. of Brain and Cognitive Science, Ewha Womans Univ., Seoul, South Korea.
authors.forename: Sooyoung
authors.initials: S
authors.lastname: Chung
authors.affiliation: Dept. of Anatomy, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Dept. of Psychiatry, School of Medicine, Gachon Univ., Incheon, South Korea.
authors.forename: Seung-Gul
authors.initials: SG
authors.lastname: Kang
authors.affiliation: Dept. of Psychiatry, Inje Univ. College of Medicine, Ilsan, South Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Park
authors.affiliation: Dept. of Psychiatry, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Ho-Kyoung
authors.initials: HK
authors.lastname: Yoon
authors.affiliation: Dept. of Psychiatry, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Leen
authors.initials: L
authors.lastname: Kim
authors.affiliation: Dept. of Biostatistics, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Hee-Jung
authors.initials: HJ
authors.lastname: Jee
authors.affiliation: Dept. of Biostatistics, Korea Univ. College of Medicine, Seoul, South Korea.
authors.forename: Hyonggin
authors.initials: H
authors.lastname: An
authors.affiliation: Dept. of Psychiatry, University of California, San Diego, CA, USA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Kripke
authors.affiliation: Dept. of Psychiatry, Korea Univ. College of Medicine, Seoul, South Korea; Dept. of Biomedical Sciences, Korea Univ. College of Medicine, Seoul, South Korea. Electronic address: leehjeong@korea.ac.kr.
authors.forename: Heon-Jeong
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000339:Affect; D017668:Age of Onset; D015415:Biomarkers; D001714:Bipolar Disorder / Q000503:physiopathology* / Q000523:psychology* / Q000534:rehabilitation / Q000628:therapy; D016022:Case-Control Studies; D002940:Circadian Rhythm / Q000235:genetics; D003863:Depression / Q000235:genetics / Q000378:metabolism; D015444:Exercise; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D008297:Male; D012463:Saliva / Q000378:metabolism; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone
keywords: Bipolar disorders; Circadian dysregulation; Circadian rhythm; Phase shift