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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. 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). 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. 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. © 2021, The Author(s).

ACHTERGROND Verzekeraars vragen in toenemende mate een getalsmatige onderbouwing van de behandelresultaten in de ggz. Daarbij baseren zij zich op de door de Stichting Benchmark ggz (sbg) aangeleverde data en procedures. sbg heeft een beperkt aantal (generieke) vragenlijsten geaccepteerd om te kunnen benchmarken. Binnen de klinische praktijk voldoen die instrumenten niet om daarmee routine outcome monitoring (rom) mee te kunnen verrichten. De behoefte bestaat om daar een veelgebruikte depressievragenlijst, de Inventory of Depressive Symptomatology (ids), voor te gebruiken. DOEL Argumenten aandragen waarom de ids een uitstekend en bruikbaar instrument is om door sbg als meetinstrument te worden geaccepteerd. METHODE Door middel van een literatuuroverzicht de kwaliteit van de ids bespreken. RESULTATEN De ids is een kwalitatief goed instrument om de ernst van depressies te meten en is tevens gevoelig om verbetering in de stemming te meten. CONCLUSIE De ids is een uitstekend instrument om rom-metingen mee te verrichten en is zonder kosten verkrijgbaar. Er wordt voor gepleit dat sbg deze vragenlijst accepteert als een van de instrumenten om te kunnen benchmarken.

BACKGROUND: The chronotype, being a morning or an evening type, can influence an individual's psychological health. Studies have shown a link between depressed mood and being an evening type; however, most studies have used symptom scales and not diagnostic criteria, and confounding factors such as sleep patterns and somatic health factors have often not been considered. This study aims to examine the association between chronotype and depressive (major depressive disorder (MDD), dysthymia) and anxiety (generalized anxiety disorder, panic disorder, agoraphobia, and social phobia) disorders diagnosed using clinical interviews, while taking into account relevant sociodemographic, clinical, somatic health, and sleep parameters. METHODS: Data from a large cohort, the Netherlands Study of Depression and Anxiety were used (n = 1,944), which included 676 currently depressed and/or anxious patients, 831 remitted patients, and 437 healthy controls. Chronotype was assessed using the Munich Chronotype Questionnaire. RESULTS: Our results showed that current depressive and/or anxiety disorders were associated with a late chronotype (β = .10, P = .004) even when adjusting for sociodemographic, somatic health, and sleep-related factors (β = .09, P = .03). When examining each type of disorder separately, MDD only, but not dysthymia or specific anxiety disorders, was associated with the late chronotype. The late chronotype also reported significant diurnal mood variation (worse mood in the morning). CONCLUSIONS: Our findings show a clear association between MDD and late chronotype (being an evening type), after controlling for a range of pertinent factors. A late chronotype is therefore associated with a current status of MDD and deserves the relevant clinical attention when considering treatments.

Background: Seasonal changes in mood and behavior are considered to be common in the general population and in patients with psychiatric disorders. However, in several studies this seasonality could not be demonstrated. The present study examined self-attributed seasonality of depressive symptoms among patients with a lifetime diagnosis of a depressive disorder (D), an anxiety disorder (A), a comorbid depressive and anxiety disorder (DA), and healthy controls (HC). Methods: The CIDI was used to establish diagnoses according to DSM-IV criteria in 2,168 participants of the Netherlands Study of Depression and Anxiety (NESDA). The Seasonal Pattern Assessment Questionnaire (SPAQ) was administered to assess variation in mood and behavior. Results: Of the 2,168 participants 53.5% reported seasonality of mood. Highest percentages of low mood were seen in the winter months. Although all groups showed this pattern of lowered mood during the winter months, D, A, and DA were significantly (P

De belangstelling voor seizoengebonden stemmingsstoornissen is het laatste decennium sterk toegenomen. Deze toename is vooral te danken aan het succes waarmee zogenaamde winterdepressies blijken te kunnen worden behandeld met sterk kunstlicht. Gerapporteerd werd dat 50-80% van de patiënten met deze stoornis volledig genas. Dit artikel geeft een beschrijving van de aard van de winterdepressie, alsmede een aantal theoretische overwegingen. Tot slot zullen enige resultaten worden weergegeven van onderzoek dat in het Academisch Ziekenhuis Groningen op dit gebied werd verricht.