Social Rhythm Regularity and the Onset of Affective Episodes in Bipolar Spectrum Individuals

Overview

Journal Bipolar Disord

Specialty Psychiatry

Date 2008 May 3

PMID 18452448

Citations 56

Authors

Gail H C Shen

Lauren B Alloy

Lyn Y Abramson

Louisa G Sylvia

Affiliations

Soon will be listed here.

Abstract

Objectives: Research suggests that bipolar disorder individuals may have less social rhythm regularity than normal controls and that this may contribute to their affective symptoms and episodes. This study examined whether regularity prospectively predicted time to onset of major depressive, hypomanic and manic episodes in a sample with bipolar spectrum disorders.

Methods: We recruited 414 undergraduate students from Temple University and University of Wisconsin diagnosed with cyclothymia, bipolar II disorder, or with no affective disorder (normal controls). Participants completed the Social Rhythm Metric at Time 1 and structured interviews approximately every four months for an average follow-up period of 33 months.

Results: Participants diagnosed with cyclothymia and bipolar II disorder reported significantly fewer regular activities than normal controls, and approximately half of these participants experienced a worsening course of their illness over the study duration. Survival analyses indicated that both diagnosis and social rhythm regularity significantly predicted the time to participants' first prospective onset of major depressive, hypomanic and manic episodes.

Conclusion: Consistent with the social zeitgeber theory, bipolar spectrum participants reported less social rhythm regularity than normal controls, which prospectively predicted the survival time to affective episodes.

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References

Davenport Y, ADLAND M . Postpartum psychoses in female and male bipolar manic-depressive patients. Am J Orthopsychiatry. 1982; 52(2):288-97. DOI: 10.1111/j.1939-0025.1982.tb02689.x. View

Ehlers C, Frank E, Kupfer D . Social zeitgebers and biological rhythms. A unified approach to understanding the etiology of depression. Arch Gen Psychiatry. 1988; 45(10):948-52. DOI: 10.1001/archpsyc.1988.01800340076012. View

Monk T, Flaherty J, Frank E, Hoskinson K, Kupfer D . The Social Rhythm Metric. An instrument to quantify the daily rhythms of life. J Nerv Ment Dis. 1990; 178(2):120-6. DOI: 10.1097/00005053-199002000-00007. View

Depue R, Slater J, Klein D, Goplerud E, Farr D . A behavioral paradigm for identifying persons at risk for bipolar depressive disorder: a conceptual framework and five validation studies. J Abnorm Psychol. 1981; 90(5):381-437. DOI: 10.1037//0021-843x.90.5.381. View

Frank E, Anderson B, Hlastala S, Luther J, Sherrill J, Houck P . Social rhythm disruption and stressful life events in the onset of bipolar and unipolar episodes. Psychol Med. 2002; 30(5):1005-16. DOI: 10.1017/s0033291799002706. View

Hyman S . Goals for research on bipolar disorder: the view from NIMH. Biol Psychiatry. 2000; 48(6):436-41. DOI: 10.1016/s0006-3223(00)00894-5. View

Hall K, Dunner D, Zeller G, Fieve R . Bipolar illness: a prospective study of life events. Compr Psychiatry. 1977; 18(5):497-502. DOI: 10.1016/0010-440x(77)90050-5. View

Suppes T, Leverich G, Keck P, Nolen W, Denicoff K, Altshuler L . The Stanley Foundation Bipolar Treatment Outcome Network. II. Demographics and illness characteristics of the first 261 patients. J Affect Disord. 2002; 67(1-3):45-59. DOI: 10.1016/s0165-0327(01)00432-3. View

Akiskal H, Djenderedjian A, Rosenthal R, Khani M . Cyclothymic disorder: validating criteria for inclusion in the bipolar affective group. Am J Psychiatry. 1977; 134(11):1227-33. DOI: 10.1176/ajp.134.11.1227. View

10.

Alloy L, Abramson L, Hogan M, Whitehouse W, Rose D, Robinson M . The Temple-Wisconsin Cognitive Vulnerability to Depression Project: lifetime history of axis I psychopathology in individuals at high and low cognitive risk for depression. J Abnorm Psychol. 2000; 109(3):403-18. View

11.

Szuba M, YAGER A, Guze B, Allen E, Baxter Jr L . Disruption of social circadian rhythms in major depression: a preliminary report. Psychiatry Res. 1992; 42(3):221-30. DOI: 10.1016/0165-1781(92)90114-i. View

12.

Monk T, Kupfer D, Frank E, Ritenour A . The Social Rhythm Metric (SRM): measuring daily social rhythms over 12 weeks. Psychiatry Res. 1991; 36(2):195-207. DOI: 10.1016/0165-1781(91)90131-8. View

13.

Prigerson H, Reynolds 3rd C, Frank E, Kupfer D, George C, Houck P . Stressful life events, social rhythms, and depressive symptoms among the elderly: an examination of hypothesized causal linkages. Psychiatry Res. 1994; 51(1):33-49. DOI: 10.1016/0165-1781(94)90045-0. View

14.

Ambelas A . Psychologically stressful events in the precipitation of manic episodes. Br J Psychiatry. 1979; 135:15-21. DOI: 10.1192/bjp.135.1.15. View

15.

Wehr T, Sack D, Rosenthal N . Sleep reduction as a final common pathway in the genesis of mania. Am J Psychiatry. 1987; 144(2):201-4. DOI: 10.1176/ajp.144.2.201. View

16.

Frank E, Hlastala S, Ritenour A, Houck P, Tu X, Monk T . Inducing lifestyle regularity in recovering bipolar disorder patients: results from the maintenance therapies in bipolar disorder protocol. Biol Psychiatry. 1997; 41(12):1165-73. DOI: 10.1016/s0006-3223(96)00241-7. View

17.

Ashman S, Monk T, Kupfer D, Clark C, Myers F, Frank E . Relationship between social rhythms and mood in patients with rapid cycling bipolar disorder. Psychiatry Res. 1999; 86(1):1-8. DOI: 10.1016/s0165-1781(99)00019-0. View

18.

Francis-Raniere E, Alloy L, Abramson L . Depressive personality styles and bipolar spectrum disorders: prospective tests of the event congruency hypothesis. Bipolar Disord. 2006; 8(4):382-99. DOI: 10.1111/j.1399-5618.2006.00337.x. View

19.

Leibenluft E, Albert P, Rosenthal N, Wehr T . Relationship between sleep and mood in patients with rapid-cycling bipolar disorder. Psychiatry Res. 1996; 63(2-3):161-8. DOI: 10.1016/0165-1781(96)02854-5. View

20.

Frank E, Kupfer D, Thase M, Mallinger A, Swartz H, Fagiolini A . Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Arch Gen Psychiatry. 2005; 62(9):996-1004. DOI: 10.1001/archpsyc.62.9.996. View