@article{ref1,
title="Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder",
journal="International journal of bipolar disorders",
year="2021",
author="Dodd, Seetal and Desai, Pratikkumar and Castro, Angela Marianne Paredes and Cappucciati, Marco and Del Zompo, Maria and Bauer, Michael and Baethge, Christopher and Ayhan, Yavuz and Aydın, Memduha and Benedetti, Francesco and Belmaker, Robert H. and Belizario, Gabriel Okawa and Belete, Tilahun and Altınbaş, Kursat and Glenn, Tasha and Vares, Edgar Arrua and Ardau, Raffaella and Angelopoulos, Elias and Andreassen, Ole A. and Belete, Habte and Behere, Prakash B. and Behere, Aniruddh P. and Becerra-Palars, Claudia and Balaban, Ceylan and Baune, Bernhard T. and Cabrera, Jorge and Berk, Michael and Cheung, Eric Y. Wo and Chen, Wei-Ling and Crowe, Marie and Chiesa, Silvia and Dallaspezia, Sara and Cuomo, Alessandro and Agaoglu, Esen and Alda, Martin and Achtyes, Eric D. and Brady, Conan and Bauer, Rita and Bellivier, Frank and Bjella, Thomas D. and Birabwa-Oketcho, Harriet and Bicakci, Şule and Bersudsky, Yuly and Donix, Markus and Etain, Bruno and Fagiolini, Andrea and Fellendorf, Frederike T. and Ferensztajn-Rochowiak, Ewa and Fiedorowicz, Jess G. and Fountoulakis, Kostas N. and Frye, Mark A. and Geoffroy, Pierre A. and Gonzalez-Pinto, Ana and Gottlieb, John F. and Grof, Paul and Haarman, Bartholomeus C. M. and Harima, Hirohiko and Hasse-Sousa, Mathias and Henry, Chantal and Høffding, Lone and Houenou, Josselin and Imbesi, Massimiliano and Isometsä, Erkki T. and Ivković, Maja and Janno, Sven and Johnsen, Simon and Kapczinski, Flavio and Karakatsoulis, Gregory N. and Kardell, Mathias and Kessing, Lars Vedel and Kim, Seong Jae and König, Barbara and Kot, Timur L. and Koval, Michael and Kunz, Mauricio and Lafer, Beny and Landén, Mikael and Larsen, Erik R. and Lenger, Melanie and Lewitzka, Ute and Licht, Rasmus W. and Lopez-Jaramillo, Carlos and MacKenzie, Alan and Madsen, Helle Østergaard and Madsen, Simone Alberte Kongstad A. and Mahadevan, Jayant and Mahardika, Agustine and Manchia, Mirko and Marsh, Wendy and Martinez-Cengotitabengoa, Mónica and Martiny, Klaus and Mashima, Yuki and McLoughlin, Declan M. and Meesters, Ybe and Melle, Ingrid and Meza-Urzúa, Fátima and Ming, Mok Yee and Monteith, Scott and Moorthy, Muthukumaran and Morken, Gunnar and Mosca, Enrica and Mozzhegorov, Anton A. and Munoz, Rodrigo and Mythri, Starlin V. and Nacef, Fethi and Nadella, Ravi K. and Nakanotani, Takako and Nielsen, René Ernst and O'Donovan, Claire and Omrani, Adel and Osher, Yamima and Ouali, Uta and Pantović-Stefanović, Maja and Pariwatcharakul, Pornjira and Petite, Joanne and Pfennig, Andrea and Ruiz, Yolanda Pica and Pilhatsch, Maximilian and Pinna, Marco and Pompili, Maurizio and Porter, Richard and Quiroz, Danilo and Rabelo-da-Ponte, Francisco Diego and Ramesar, Raj and Rasgon, Natalie and Ratta-Apha, Woraphat and Ratzenhofer, Michaela and Redahan, Maria and Reddy, M. S. and Reif, Andreas and Reininghaus, Eva Z. and Richards, Jenny Gringer and Ritter, Philipp and Rybakowski, Janusz K. and Sathyaputri, Leela and Scippa, Ângela M. and Simhandl, Christian and Severus, Emanuel and Smith, Daniel and Smith, José and Stackhouse, Paul W. Jr and Stein, Dan J. and Stilwell, Kellen and Strejilevich, Sergio and Su, Kuan-Pin and Subramaniam, Mythily and Sulaiman, Ahmad Hatim and Suominen, Kirsi and Tanra, Andi J. and Tatebayashi, Yoshitaka and Teh, Wen Lin and Tondo, Leonardo and Torrent, Carla and Tuinstra, Daniel and Uchida, Takahito and Vaaler, Arne E. and Veeh, Julia and Vieta, Eduard and Viswanath, Biju and Yoldi-Negrete, Maria and Yalcinkaya, Oguz Kaan and Young, Allan H. and Zgueb, Yosra and Whybrow, Peter C.",
volume="9",
number="1",
pages="e26-e26",
abstract="BACKGROUND: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. <br><br>METHODS: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). <br><br>RESULTS: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. <br><br>CONCLUSION: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.<p /> <p>Language: en</p>",
language="en",
issn="2194-7511",
doi="10.1186/s40345-021-00231-7",
url="http://dx.doi.org/10.1186/s40345-021-00231-7"
}