Primavera Diego, Cossu Giulia, Marchegiani Sonia, Preti Antonio, Nardi Antonio Egidio
Department of Medical Sciences and Public Health, University of Cagliari, Italy Section of Psychiatry, Cagliari, Italy.
Department of Mental Health, ASL Medio Campidano, Cagliari, Italy.
Clin Pract Epidemiol Ment Health. 2024 Apr 19;20:e17450179293272. doi: 10.2174/0117450179293272240328053722. eCollection 2024.
This editorial explores the role of hyperactivity and social rhythm dysregulation in bipolar disorder (BD) and related syndromes. Social Rhythm Dysregulation Syndrome (DYMERS) is proposed as a common vulnerability across various disorders, including panic disorder (PD), attention deficit hyperactivity disorder, and post-traumatic stress disorder. A study conducted on a sample of elderly individuals participating in an active aging study investigated whether individuals with PD exhibit higher biological rhythm dysregulation compared to those without PD. The sample, consisting of 119 individuals, revealed that those with a lifetime PD diagnosis scored significantly higher on the dysregulation of biological rhythms scale compared to those without panic disorder. A higher prevalence of depressive episodes was found in individuals with PD at the time of the interview. Notably, a small sample of elderly individuals with panic disorder, voluntarily selected for a physical exercise trial, showed a significantly higher level of dysregulation of social rhythms compared to those without panic disorder. This study opens a debate on the accuracy of paper and pencil screening tests for bipolar disorders, especially regarding false positives in individuals with panic disorder. Our hypothesis is that DYMERS could be a shared vulnerability substrate for various disorders, serving as a basis for bipolar onset in the presence of a hyperactivity profile, even with genetic features. The data collected from older adults suggest that social rhythm dysregulation is a typical feature of PD, regardless of the coexistence of a depressive episode. While the study has limitations due to a small sample size, the findings warrant careful analysis and suggest the need for larger-scale replication studies. If confirmed, the dysregulation of rhythms and its association with depressive disorders highlight a significant area of vulnerability for serious psychopathological disorders, emphasizing the importance of extending research to younger populations.
这篇社论探讨了多动和社会节律失调在双相情感障碍（BD）及相关综合征中的作用。社会节律失调综合征（DYMERS）被认为是包括惊恐障碍（PD）、注意力缺陷多动障碍和创伤后应激障碍在内的各种疾病的共同易感性因素。一项针对参与积极老龄化研究的老年个体样本进行的研究，调查了患有PD的个体与未患PD的个体相比，是否表现出更高的生物节律失调。该样本由119名个体组成，结果显示，终生诊断为PD的个体在生物节律失调量表上的得分显著高于未患惊恐障碍的个体。在访谈时，患有PD的个体中抑郁发作的患病率更高。值得注意的是，一小部分自愿参加体育锻炼试验的患有惊恐障碍的老年个体，与未患惊恐障碍的个体相比，表现出显著更高的社会节律失调水平。这项研究引发了关于双相情感障碍纸笔筛查测试准确性的讨论，尤其是关于惊恐障碍个体中的假阳性问题。我们的假设是，DYMERS可能是各种疾病的共同易感性基础，即使存在遗传特征，在有多动特征的情况下也可作为双相情感障碍发病的基础。从老年人收集的数据表明，社会节律失调是PD的一个典型特征，无论是否并存抑郁发作。虽然该研究因样本量小存在局限性，但研究结果值得仔细分析，并表明需要进行更大规模的重复研究。如果得到证实，节律失调及其与抑郁症的关联突出了严重精神病理障碍的一个重要脆弱领域，强调了将研究扩展到年轻人群体的重要性。
