Citation

Palagini L, Miniati M, Marazziti D, Massa L, Grassi L, Geoffroy PA. Clin. Neuropsychiatry 2022; 19(3): 174-186.

Copyright

(Copyright © 2022, Giovanni Fioriti Editore)

DOI

10.36131/cnfioritieditore20220306

PMID

unavailable

Abstract

OBJECTIVE: The study aimed to investigate the possible impact of resilience and emotion dysregulation on the clinical manifestations of bipolar disorders (BDs) focusing on the possible role of circadian rhythm alterations.

METHOD: A sample of 197 inpatients suffering from BD of type I (BDI) or II (BDII) were assessed during a major depressive episode using the Structural Clinical Interview for DSM-5 (SCID-5), the Beck Depression Inventory-II (BDI-II), the Young Mania Rating Scale (YMRS), Resilience Scale for Adults (RSA), Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Difficulties in Emotion Regulation Scale (DERS) and the Scale for Suicide Ideation (SSI). Participants with or without circadian rhythm disturbances as measured with Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), were compared; regression and mediation analyses were computed.

RESULTS: Participants with circadian rhythms disturbances showed a greater severity of depressive symptoms, of suicidal risk, lower resilience and more disturbances in emotion regulation including impulsivity and regulatory strategies. The logistic regression revealed that circadian rhythm disturbances was related to depressive symptoms (O.R. 4.0), suicidal risk (OR 2.51), emotion dysregulation (OR 2.28) and low resilience (OR 2.72). At the mediation analyses, circadian rhythm alterations showed an indirect effect on depressive symptoms by impairing resilience (Z= 3.17, p=0.0014)/ emotional regulation (Z= 4.36, p<0.001) and on suicidal risk by affecting resilience (Z= 2.00, p=0.045) and favoring impulsivity (Z= 2.14, p=0.032).

CONCLUSIONS: The present findings may show that circadian rhythm alterations might play a key role in BD manifestations, as being correlated with more severe clinical presentations of depressive symptoms, suicidal risk, impaired resilience and emotional regulation. Addressing circadian rhythm alterations might potentially promote resilience and emotion regulation hence improving mood symptoms and suicidal risk in BDs. © 2022 Giovanni Fioriti Editore s.r.l.

Language: en

Keywords

adult; antidepressant agent; anxiety disorder; Article; Beck Depression Inventory; benzodiazepine derivative; biological rhythms interview of assessment in neuropsychiatry; bipolar disorder; bipolar I disorder; bipolar II disorder; chronobiology; circadian rhythm; circadian rhythms; controlled study; diagnostic test accuracy study; difficulties in emotion regulation scale; DSM-5; emotion dysregulation; emotional disorder; female; human; human experiment; impulsiveness; impulsivity; lithium; major clinical study; major depression; male; mediation analysis; middle aged; mood change; mood stabilizer; mood symptoms; neuroleptic agent; neuropsychiatry; posttraumatic stress disorder; psychological resilience; questionnaire; resilience; Resilience Scale for Adults; sensitivity and specificity; sleep disordered breathing; social cohesion; social competence; social life; suicidal ideation; suicidal risk; suicide; Young Mania Rating Scale