Goldschmied Jennifer R, Palermo Emma, Yocum Anastasia, McInnis Melvin, Gehrman Philip
Department of Psychiatry, University of Pennsylvania, 3535 Market St., Philadelphia, PA, 19104, USA.
Center for Depression, Anxiety, and Stress Research, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA.
J Psychiatr Res. 2025 Jan;181:23-28. doi: 10.1016/j.jpsychires.2024.11.030. Epub 2024 Nov 19.
Sleep and circadian disturbances play a crucial role in psychiatric disorders, especially mood disorders such as bipolar disorder. This study investigated the predictive value of self-reported sleep and circadian factors for suicide risk in individuals with bipolar type I and bipolar type II disorder.
Data were collected from the Heinz C. Prechter Longitudinal Study of Bipolar Disorder. Suicide risk was evaluated using the Columbia Suicide-Severity Rating Scale, while the sleep and circadian factors were extracted from the Pittsburgh Sleep Quality Index, Hamilton Depression Rating Scale, and Munich Chronotype Questionnaire.
A stepwise selection procedure identified significant predictors for each group. Results showed that suicide risk in individuals with bipolar disorder type I was associated with insomnia, whereas risk in bipolar disorder type II was associated with evening chronotype.
These findings indicate that specific sleep and circadian disturbance variables confer unique risk for suicide in the subtypes of bipolar disorder. This highlights the importance of conducting a thorough sleep and circadian assessment in clinical practice and emphasizes the need for clinical trials investigating the impact of sleep and circadian interventions on mitigating suicide risk in individuals with bipolar disorder.
睡眠和昼夜节律紊乱在精神疾病中起着关键作用，尤其是在双相情感障碍等情绪障碍中。本研究调查了自我报告的睡眠和昼夜节律因素对I型和II型双相情感障碍患者自杀风险的预测价值。
数据来自海因茨·C·普雷chter双相情感障碍纵向研究。使用哥伦比亚自杀严重程度评定量表评估自杀风险，而睡眠和昼夜节律因素则从匹兹堡睡眠质量指数、汉密尔顿抑郁评定量表和慕尼黑昼夜类型问卷中提取。
逐步选择程序确定了每组的显著预测因素。结果表明，I型双相情感障碍患者的自杀风险与失眠有关，而II型双相情感障碍患者的风险与晚睡型昼夜节律有关。
这些发现表明，特定的睡眠和昼夜节律紊乱变量在双相情感障碍亚型中赋予了独特的自杀风险。这突出了在临床实践中进行全面睡眠和昼夜节律评估的重要性，并强调了开展临床试验以研究睡眠和昼夜节律干预对降低双相情感障碍患者自杀风险影响的必要性。
