Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders

• Published in: Current psychiatry reports 2017-04, Vol.19 (4), p.21-21, Article 21
• Main Authors: Alloy, Lauren B., Ng, Tommy H., Titone, Madison K., Boland, Elaine M.
• Format: Article
• Language: English
• Subjects: Biological clocks; Bipolar disorder; Bipolar Disorder - diagnosis; Bipolar Disorder - physiopathology; Chronobiology Disorders - complications; Chronobiology Disorders - psychology; Circadian rhythm; Circadian Rhythm - physiology; Humans; Medicine; Medicine & Public Health; Melatonin - metabolism; Psychiatry; Psychopathology; Section Editor; Sleep - physiology; Sleep Disorders (P Gehrman; Topical Collection on Sleep Disorders
• ISSN: 1523-3812; 1535-1645
• DOI: 10.1007/s11920-017-0772-z

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. Summary 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.