Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders.
OBJECTIVE
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.


RESULTS
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.
Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA. lalloy@temple.edu.
Lauren B
LB
Alloy
Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
Tommy H
TH
Ng
Department of Psychology, Temple University, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
Madison K
MK
Titone
Corporal Michael J. Crescenz Veterans Affairs Medical Center and University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Elaine M
EM
Boland
D001714:Bipolar Disorder / Q000175:diagnosis / Q000503:physiopathology; D021081:Chronobiology Disorders / Q000150:complications / Q000523:psychology; D002940:Circadian Rhythm / Q000502:physiology; D006801:Humans; D008550:Melatonin / Q000378:metabolism; D011599:Psychopathology; D012890:Sleep / Q000502:physiology
D008550:Melatonin
bipolar spectrum disorders; chronotype; circadian rhythms; melatonin; social rhythms; zeitgeber