Actigraphic assessment of circadian activity and sleep patterns in bipolar disorder

被引:240
作者
Jones, SH [1 ]
Hare, DJ [1 ]
Evershed, K [1 ]
机构
[1] Univ Manchester, Acad Div Clin Psychol, Manchester, Lancs, England
关键词
activity patterns; bipolar disorder; circadian rhythms; instability; sleep; therapy;
D O I
10.1111/j.1399-5618.2005.00187.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: Theoretical accounts and psychological interventions for bipolar disorder indicate that disruption of circadian rhythms is important, both in affective episodes and as a vulnerability factor in subsyndromal periods. This study aims at assessing both circadian activity and sleep patterns using actigraphy within a bipolar sample experiencing low levels of subsyndromal symptoms. It is hypothesized that such participants will display circadian activity disruption in spite of low levels of symptoms. Methods: This study employed a mixed design with cross-sectional assessment of mood and week-long (7-day) recording of actigraphy data. All clinical participants were psychiatric outpatients within a UK NHS Hospital. Nineteen bipolar patients and 19 age- and gender-matched controls wore an actigraph for 7 days to obtain sleep and circadian activity data. SCID was used to confirm DSM-IV diagnostic status. Self-report measures of mood were obtained from both groups. Results: Bipolar patients were found to have less stable and more variable circadian activity patterns than controls. Regression analysis indicated that variability alone was a significant independent predictor of diagnostic group. There was evidence from raw activity data that bipolar patients were also less active than controls. These differences were not associated with levels of subsyndromal symptoms. Bipolar patients did not differ from controls on any of the sleep indices used. Conclusions: Circadian activity disruption is apparent in bipolar patients even when not acutely ill. This finding is not associated with the presence of sleep disturbance. Should such patterns be replicated interventions to address both circadian instability and individual attributions for the effects of such instability are likely to be relevant to successful psychological interventions.
引用
收藏
页码:176 / 186
页数:11
相关论文
共 58 条
[1]
Alloy L.B., 1999, J COGN PSYCHOTHER, V13, P21, DOI [10.1891/0889-8391.13.1.21, DOI 10.1891/0889-8391.13.1.21]
[2]
Relationship between social rhythms and mood in patients with rapid cycling bipolar disorder [J].
Ashman, SB ;
Monk, TH ;
Kupfer, DJ ;
Clark, CH ;
Myers, FS ;
Frank, E ;
Leibenluft, E .
PSYCHIATRY RESEARCH, 1999, 86 (01) :1-8
[3]
ATKINSON M, 1975, CHRONOBIOLOGIA, V2, P325
[4]
BASCO MR, 1996, COGNITIVE BEHAV THER, V19
[5]
BAUER MS, 1991, ARCH GEN PSYCHIAT, V48, P807
[6]
The Internal State Scale: replication of its discriminating abilities in a multisite, public sector sample [J].
Bauer, MS ;
Vojta, C ;
Kinosian, B ;
Altshuler, L ;
Glick, H .
BIPOLAR DISORDERS, 2000, 2 (04) :340-346
[7]
MANIA RATING-SCALE - SCALE CONSTRUCTION AND INTER-OBSERVER AGREEMENT [J].
BECH, P ;
RAFAELSEN, OJ ;
KRAMP, P ;
BOLWIG, TG .
NEUROPHARMACOLOGY, 1978, 17 (06) :430-431
[8]
Beck A.T., 1988, BECK HOPELESSNESS SC
[9]
Beck A.T., 1987, BECK DEPRESSION INVE
[10]
PSYCHOMETRIC PROPERTIES OF THE BECK DEPRESSION INVENTORY - 25 YEARS OF EVALUATION [J].
BECK, AT ;
STEER, RA ;
GARBIN, MG .
CLINICAL PSYCHOLOGY REVIEW, 1988, 8 (01) :77-100