Circadian Phase Preference in Pediatric Bipolar Disorder

Journal of Clinical Medicine

Kerri L. Kim²  Alexandra B. Weissman²  Megan E. Puzia²  Grace K. Cushman²  Karen E. Seymour²  Ezra Wegbreit²  Mary A. Carskadon¹ 

[1]Chronobiology and Sleep Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI 02915, USA

[2] E-Mail:

[3]PediMIND Program at E.P. Bradley Hospital and the Alpert Medical School, Brown University, Providence, RI 02915, USA

[4] E-Mails:

关键词: child;    adolescent;    bipolar disorder;    circadian;   

DOI  :  10.3390/jcm3010255

来源: mdpi

【 摘 要 】

Pediatric bipolar disorder (BD) rates have notably increased over the past three decades. Given the significant morbidity and mortality associated with BD, efforts are needed to identify factors useful in earlier detection to help address this serious public health concern. Sleep is particularly important to consider given the sequelae of disrupted sleep on normative functioning and that sleep is included in diagnostic criteria for both Major Depressive and Manic Episodes. Here, we examine one component of sleep—i.e., circadian phase preference with the behavioral construct of morningness/eveningness (M/E). In comparing 30 BD and 45 typically developing control (TDC) participants, ages 7–17 years, on the Morningness-Eveningness Scale for Children (MESC), no between-group differences emerged. Similar results were found when comparing three groups (BD−ADHD; BD+ADHD; TDC). Consistent with data available on circadian phase preference in adults with BD, however, we found that BD adolescents, ages 13 years and older, endorsed significantly greater eveningness compared to their TDC peers. While the current findings are limited by reliance on subjective report and the high-rate of comorbid ADHD among the BD group, this finding that BD teens demonstrate an exaggerated shift towards eveningness than would be developmentally expected is important. Future studies should compare the circadian rhythms across the lifespan for individuals diagnosed with BD, as well as identify the point at which BD youth part ways with their healthy peers in terms of phase preference. In addition, given our BD sample was overall euthymic, it may be that M/E is more state vs. trait specific in latency age youth. Further work would benefit from assessing circadian functioning using a combination of rating forms and laboratory-based measures. Improved understanding of sleep in BD may identify behavioral targets for inclusion in prevention and intervention protocols.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.