Psychiatric Clinic, Department of Clinical and Experimental Medicine, University Hospital, Azienda Ospedaliero-Universitaria Pisana- AUOP, Pisa, Italy.
Psychiatric Clinic, Department of Clinical and Experimental Medicine, University Hospital, Azienda Ospedaliero-Universitaria Pisana- AUOP, Pisa, Italy.
Psychiatry Res. 2019 Jan;271:272-278. doi: 10.1016/j.psychres.2018.11.056. Epub 2018 Nov 24.
In Bipolar Disorder, chronobiological rhythm alterations play a key role by negatively influencing its entire trajectory. Our aim was to assess their potential association with emotion dysregulation and suicidality in subjects with Bipolar Disorder. Eighty-five patients with Bipolar Disorder - II depressive episode with mixed features were recruited and 35 as healthy controls. Subjects were evaluated with SCID-DSM-5, the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), the DERS: Difficulties in Emotion Regulation Scale, the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS) and the Scale for Suicide Ideation (SSI). When compared to healthy controls, subjects with bipolar disorder showed significantly higher scores in the BRIAN, the DERS, the BDI-II, the YMRS and the SSI total scores. Chronobiological dis-rhythmicity was significantly related to the severity of depressive symptoms, emotion dysregulation, and suicidality in bipolar individuals. In particular, the dis-rythmicity of the sleep/wake pattern showed a significant correlation with manic symptoms, the dis-rythmicity of daily activities with depressive symptoms and emotion dysregulation and that of social life with suicidality. Emotion dysregulation played as a mediator for the association between chronobiological dis-rhythmicity and depressive symptoms (mediated effect = 3.25, p = 0.001) and for social life dis-rhythmicity and suicidality (mediated effect = 2.52, p = 0.011) as well. Therefore, our findings showed that chronobiological dis-rhythmicity in bipolar individuals was related to the severity of mood swings, emotion dysregulation and suicidality. The assessment of potential alteration in chronobiological rhythms should be investigated in the clinical setting in subjects with bipolar disorder to identify those who may benefit from early chronobiological intervention.
在双相情感障碍中，生物节律紊乱通过对其整个病程产生负面影响而起着关键作用。我们的目的是评估其与双相情感障碍患者的情绪失调和自杀意念的潜在关联。共招募了 85 名双相情感障碍 - II 型抑郁发作伴混合特征的患者和 35 名健康对照者。使用 SCID-DSM-5、神经精神生物学节律访谈评估（BRIAN）、情绪调节困难量表（DERS）、贝克抑郁量表 II 版（BDI-II）、杨氏躁狂评定量表（YMRS）和自杀意念量表（SSI）对受试者进行评估。与健康对照组相比，双相情感障碍患者的 BRIAN、DERS、BDI-II、YMRS 和 SSI 总分明显较高。生物节律紊乱与双相个体抑郁症状、情绪失调和自杀意念的严重程度显著相关。特别是，睡眠/觉醒模式的节律紊乱与躁狂症状显著相关，日常活动的节律紊乱与抑郁症状和情绪失调相关，社会生活的节律紊乱与自杀意念相关。情绪失调作为生物节律紊乱与抑郁症状之间关联的中介（中介效应=3.25，p=0.001）以及社会生活节律紊乱与自杀意念之间关联的中介（中介效应=2.52，p=0.011）。因此，我们的研究结果表明，双相情感障碍患者的生物节律紊乱与情绪波动、情绪失调和自杀意念的严重程度有关。应在双相情感障碍患者的临床环境中评估潜在的生物节律紊乱改变，以确定那些可能受益于早期生物节律干预的患者。
