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1. Exploratory study of ultraviolet B (UVB) radiation and age of onset of bipolar disorder

Author

Michael Bauer, Tasha Glenn, Eric D. Achtyes, Martin Alda, Esen Agaoglu, Kürsat Altınbaş, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Memduha Aydin, Yavuz Ayhan, Christopher Baethge, Rita Bauer, Bernhard T. Baune, Ceylan Balaban, Claudia Becerra-Palars, Aniruddh P. Behere, Prakash B. Behere, Habte Belete, Tilahun Belete, Gabriel Okawa Belizario, Frank Bellivier, Robert H. Belmaker, Francesco Benedetti, Michael Berk, Yuly Bersudsky, Şule Bicakci, Harriet Birabwa-Oketcho, Thomas D. Bjella, Conan Brady, Jorge Cabrera, Marco Cappucciati, Angela Marianne Paredes Castro, Wei-Ling Chen, Eric Y. W. Cheung, Silvia Chiesa, Marie Crowe, Alessandro Cuomo, Sara Dallaspezia, Maria Del Zompo, Pratikkumar Desai, Seetal Dodd, Bruno Etain, Andrea Fagiolini, Frederike T. Fellendorf, Ewa Ferensztajn-Rochowiak, Jess G. Fiedorowicz, Kostas N. Fountoulakis, Mark A. Frye, Pierre A. Geoffroy, Michael J. Gitlin, Ana Gonzalez-Pinto, John F. Gottlieb, Paul Grof, Bartholomeus C. M. Haarman, Hirohiko Harima, Mathias Hasse-Sousa, Chantal Henry, Lone Hoffding, Josselin Houenou, Massimiliano Imbesi, Erkki T. Isometsä, Maja Ivkovic, Sven Janno, Simon Johnsen, Flávio Kapczinski, Gregory N. Karakatsoulis, Mathias Kardell, Lars Vedel Kessing, Seong Jae Kim, Barbara König, Timur L. Kot, Michael Koval, Mauricio Kunz, Beny Lafer, Mikael Landén, Erik R. Larsen, Melanie Lenger, Rasmus W. Licht, Carlos Lopez-Jaramillo, Alan MacKenzie, Helle Østergaard Madsen, Simone Alberte Kongstad A. Madsen, Jayant Mahadevan, Agustine Mahardika, Mirko Manchia, Wendy Marsh, Monica Martinez-Cengotitabengoa, Julia Martini, Klaus Martiny, Yuki Mashima, Declan M. McLoughlin, Ybe Meesters, Ingrid Melle, Fátima Meza-Urzúa, Pavol Mikolas, Yee Ming Mok, Scott Monteith, Muthukumaran Moorthy, Gunnar Morken, Enrica Mosca, Anton A. Mozzhegorov, Rodrigo Munoz, Starlin V. Mythri, Fethi Nacef, Ravi K. Nadella, Takako Nakanotani, René Ernst Nielsen, Claire O’Donovan, Adel Omrani, Yamima Osher, Uta Ouali, Maja Pantovic-Stefanovic, Pornjira Pariwatcharakul, Joanne Petite, Johannes Petzold, Andrea Pfennig, Yolanda Pica Ruiz, Marco Pinna, Maurizio Pompili, Richard J. Porter, Danilo Quiroz, Francisco Diego Rabelo-da-Ponte, Raj Ramesar, Natalie Rasgon, Woraphat Ratta-apha, Michaela Ratzenhofer, Maria Redahan, M. S. Reddy, Andreas Reif, Eva Z. Reininghaus, Jenny Gringer Richards, Philipp Ritter, Janusz K. Rybakowski, Leela Sathyaputri, Angela M. Scippa, Christian Simhandl, Daniel Smith, José Smith, Paul W. Stackhouse, Dan J. Stein, Kellen Stilwell, Sergio Strejilevich, Kuan-Pin Su, Mythily Subramaniam, Ahmad Hatim Sulaiman, Kirsi Suominen, Andi J. Tanra, Yoshitaka Tatebayashi, Wen Lin Teh, Leonardo Tondo, Carla Torrent, Daniel Tuinstra, Takahito Uchida, Arne E. Vaaler, Eduard Vieta, Biju Viswanath, Maria Yoldi-Negrete, Oguz Kaan Yalcinkaya, Allan H. Young, Yosra Zgueb, and Peter C. Whybrow

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurophysiology and neuropsychology, QP351-495
Abstract

Abstract Background Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. Methods Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. Results The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. Conclusion UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.

Published
2023
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2. Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

Author

Michael Bauer, Tasha Glenn, Eric D. Achtyes, Martin Alda, Esen Agaoglu, Kürşat Altınbaş, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Edgar Arrua Vares, Memduha Aydin, Yavuz Ayhan, Christopher Baethge, Rita Bauer, Bernhard T. Baune, Ceylan Balaban, Claudia Becerra-Palars, Aniruddh P. Behere, Prakash B. Behere, Habte Belete, Tilahun Belete, Gabriel Okawa Belizario, Frank Bellivier, Robert H. Belmaker, Francesco Benedetti, Michael Berk, Yuly Bersudsky, Şule Bicakci, Harriet Birabwa-Oketcho, Thomas D. Bjella, Conan Brady, Jorge Cabrera, Marco Cappucciati, Angela Marianne Paredes Castro, Wei-Ling Chen, Eric Y. Wo Cheung, Silvia Chiesa, Marie Crowe, Alessandro Cuomo, Sara Dallaspezia, Maria Del Zompo, Pratikkumar Desai, Seetal Dodd, Markus Donix, Bruno Etain, Andrea Fagiolini, Frederike T. Fellendorf, Ewa Ferensztajn-Rochowiak, Jess G. Fiedorowicz, Kostas N. Fountoulakis, Mark A. Frye, Pierre A. Geoffroy, Ana Gonzalez-Pinto, John F. Gottlieb, Paul Grof, Bartholomeus C. M. Haarman, Hirohiko Harima, Mathias Hasse-Sousa, Chantal Henry, Lone Høffding, Josselin Houenou, Massimiliano Imbesi, Erkki T. Isometsä, Maja Ivkovic, Sven Janno, Simon Johnsen, Flávio Kapczinski, Gregory N. Karakatsoulis, Mathias Kardell, Lars Vedel Kessing, Seong Jae Kim, Barbara König, Timur L. Kot, Michael Koval, Mauricio Kunz, Beny Lafer, Mikael Landén, Erik R. Larsen, Melanie Lenger, Ute Lewitzka, Rasmus W. Licht, Carlos Lopez-Jaramillo, Alan MacKenzie, Helle Østergaard Madsen, Simone Alberte Kongstad A. Madsen, Jayant Mahadevan, Agustine Mahardika, Mirko Manchia, Wendy Marsh, Monica Martinez-Cengotitabengoa, Klaus Martiny, Yuki Mashima, Declan M. McLoughlin, Ybe Meesters, Ingrid Melle, Fátima Meza-Urzúa, Mok Yee Ming, Scott Monteith, Muthukumaran Moorthy, Gunnar Morken, Enrica Mosca, Anton A. Mozzhegorov, Rodrigo Munoz, Starlin V. Mythri, Fethi Nacef, Ravi K. Nadella, Takako Nakanotani, René Ernst Nielsen, Claire O‘Donovan, Adel Omrani, Yamima Osher, Uta Ouali, Maja Pantovic-Stefanovic, Pornjira Pariwatcharakul, Joanne Petite, Andrea Pfennig, Yolanda Pica Ruiz, Maximilian Pilhatsch, Marco Pinna, Maurizio Pompili, Richard Porter, Danilo Quiroz, Francisco Diego Rabelo-da-Ponte, Raj Ramesar, Natalie Rasgon, Woraphat Ratta-apha, Michaela Ratzenhofer, Maria Redahan, M. S. Reddy, Andreas Reif, Eva Z. Reininghaus, Jenny Gringer Richards, Philipp Ritter, Janusz K. Rybakowski, Leela Sathyaputri, Ângela M. Scippa, Christian Simhandl, Emanuel Severus, Daniel Smith, José Smith, Paul W. Stackhouse, Dan J. Stein, Kellen Stilwell, Sergio Strejilevich, Kuan-Pin Su, Mythily Subramaniam, Ahmad Hatim Sulaiman, Kirsi Suominen, Andi J. Tanra, Yoshitaka Tatebayashi, Wen Lin Teh, Leonardo Tondo, Carla Torrent, Daniel Tuinstra, Takahito Uchida, Arne E. Vaaler, Julia Veeh, Eduard Vieta, Biju Viswanath, Maria Yoldi-Negrete, Oguz Kaan Yalcinkaya, Allan H. Young, Yosra Zgueb, and Peter C. Whybrow

Subjects
Bipolar disorder, Suicide, Sunlight, Solar insolation, Psychiatry, Circadian, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurophysiology and neuropsychology, QP351-495
Abstract

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. 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

Published
2021
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3. Association between polarity of first episode and solar insolation in bipolar I disorder

Author

Michael Bauer, Tasha Glenn, Eric D. Achtyes, Martin Alda, Esen Agaoglu, Kürşat Altınbaş, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Memduha Aydin, Yavuz Ayhan, Christopher Baethge, Rita Bauer, Bernhard T. Baune, Ceylan Balaban, Claudia Becerra-Palars, Aniruddh P. Behere, Prakash B. Behere, Habte Belete, Tilahun Belete, Gabriel Okawa Belizario, Frank Bellivier, Robert H. Belmaker, Francesco Benedetti, Michael Berk, Yuly Bersudsky, Şule Bicakci, Harriet Birabwa-Oketcho, Thomas D. Bjella, Conan Brady, Jorge Cabrera, Marco Cappucciati, Angela Marianne Paredes Castro, Wei-Ling Chen, Eric Y.W. Cheung, Silvia Chiesa, Marie Crowe, Alessandro Cuomo, Sara Dallaspezia, Maria Del Zompo, Pratikkumar Desai, Seetal Dodd, Bruno Etain, Andrea Fagiolini, Frederike T. Fellendorf, Ewa Ferensztajn-Rochowiak, Jess G. Fiedorowicz, Kostas N. Fountoulakis, Mark A. Frye, Pierre A. Geoffroy, Ana Gonzalez-Pinto, John F. Gottlieb, Paul Grof, Bartholomeus C.M. Haarman, Hirohiko Harima, Mathias Hasse-Sousa, Chantal Henry, Lone Høffding, Josselin Houenou, Massimiliano Imbesi, Erkki T. Isometsä, Maja Ivkovic, Sven Janno, Simon Johnsen, Flávio Kapczinski, Gregory N. Karakatsoulis, Mathias Kardell, Lars Vedel Kessing, Seong Jae Kim, Barbara König, Timur L. Kot, Michael Koval, Mauricio Kunz, Beny Lafer, Mikael Landén, Erik R. Larsen, Melanie Lenger, Ute Lewitzka, Rasmus W. Licht, Carlos Lopez-Jaramillo, Alan MacKenzie, Helle Østergaard Madsen, Simone Alberte Kongstad A. Madsen, Jayant Mahadevan, Agustine Mahardika, Mirko Manchia, Wendy Marsh, Monica Martinez-Cengotitabengoa, Klaus Martiny, Yuki Mashima, Declan M. McLoughlin, Ybe Meesters, Ingrid Melle, Fátima Meza-Urzúa, Yee Ming Mok, Scott Monteith, Muthukumaran Moorthy, Gunnar Morken, Enrica Mosca, Anton A. Mozzhegorov, Rodrigo Munoz, Starlin V. Mythri, Fethi Nacef, Ravi K. Nadella, Takako Nakanotani, René Ernst Nielsen, Claire O'Donovan, Adel Omrani, Yamima Osher, Uta Ouali, Maja Pantovic-Stefanovic, Pornjira Pariwatcharakul, Joanne Petite, Andrea Pfennig, Yolanda Pica Ruiz, Marco Pinna, Maurizio Pompili, Richard Porter, Danilo Quiroz, Francisco Diego Rabelo-da-Ponte, Raj Ramesar, Natalie Rasgon, Woraphat Ratta-apha, Michaela Ratzenhofer, Maria Redahan, M.S. Reddy, Andreas Reif, Eva Z. Reininghaus, Jenny Gringer Richards, Philipp Ritter, Janusz K. Rybakowski, Leela Sathyaputri, Ângela M. Scippa, Christian Simhandl, Daniel Smith, José Smith, Paul W. Stackhouse, Dan J. Stein, Kellen Stilwell, Sergio Strejilevich, Kuan-Pin Su, Mythily Subramaniam, Ahmad Hatim Sulaiman, Kirsi Suominen, Andi J. Tanra, Yoshitaka Tatebayashi, Wen Lin Teh, Leonardo Tondo, Carla Torrent, Daniel Tuinstra, Takahito Uchida, Arne E. Vaaler, Eduard Vieta, Biju Viswanath, Maria Yoldi-Negrete, Oguz Kaan Yalcinkaya, Allan H. Young, Yosra Zgueb, Peter C. Whybrow, Clinical Cognitive Neuropsychiatry Research Program (CCNP), Bauer, Michael, Glenn, Tasha, Achtyes, Eric D, Alda, Martin, Agaoglu, Esen, Altınbaş, Kürşat, Andreassen, Ole A, Angelopoulos, Elia, Ardau, Raffaella, Aydin, Memduha, Ayhan, Yavuz, Baethge, Christopher, Bauer, Rita, Baune, Bernhard T, Balaban, Ceylan, Becerra-Palars, Claudia, Behere, Aniruddh P, Behere, Prakash B, Belete, Habte, Belete, Tilahun, Belizario, Gabriel Okawa, Bellivier, Frank, Belmaker, Robert H, Benedetti, Francesco, Berk, Michael, Bersudsky, Yuly, Bicakci, Şule, Birabwa-Oketcho, Harriet, Bjella, Thomas D, Brady, Conan, Cabrera, Jorge, Cappucciati, Marco, Castro, Angela Marianne Parede, Chen, Wei-Ling, Cheung, Eric Y W, Chiesa, Silvia, Crowe, Marie, Cuomo, Alessandro, Dallaspezia, Sara, Del Zompo, Maria, Desai, Pratikkumar, Dodd, Seetal, Etain, Bruno, Fagiolini, Andrea, Fellendorf, Frederike T, Ferensztajn-Rochowiak, Ewa, Fiedorowicz, Jess G, Fountoulakis, Kostas N, Frye, Mark A, Geoffroy, Pierre A, Gonzalez-Pinto, Ana, Gottlieb, John F, Grof, Paul, Haarman, Bartholomeus C M, Harima, Hirohiko, Hasse-Sousa, Mathia, Henry, Chantal, Høffding, Lone, Houenou, Josselin, Imbesi, Massimiliano, Isometsä, Erkki T, Ivkovic, Maja, Janno, Sven, Johnsen, Simon, Kapczinski, Flávio, Karakatsoulis, Gregory N, Kardell, Mathia, Kessing, Lars Vedel, Kim, Seong Jae, König, Barbara, Kot, Timur L, Koval, Michael, Kunz, Mauricio, Lafer, Beny, Landén, Mikael, Larsen, Erik R, Lenger, Melanie, Lewitzka, Ute, Licht, Rasmus W, Lopez-Jaramillo, Carlo, Mackenzie, Alan, Madsen, Helle Østergaard, Madsen, Simone Alberte Kongstad A, Mahadevan, Jayant, Mahardika, Agustine, Manchia, Mirko, Marsh, Wendy, Martinez-Cengotitabengoa, Monica, Martiny, Klau, Mashima, Yuki, Mcloughlin, Declan M, Meesters, Ybe, Melle, Ingrid, Meza-Urzúa, Fátima, Mok, Yee Ming, Monteith, Scott, Moorthy, Muthukumaran, Morken, Gunnar, Mosca, Enrica, Mozzhegorov, Anton A, Munoz, Rodrigo, Mythri, Starlin V, Nacef, Fethi, Nadella, Ravi K, Nakanotani, Takako, Nielsen, René Ernst, O'Donovan, Claire, Omrani, Adel, Osher, Yamima, Ouali, Uta, Pantovic-Stefanovic, Maja, Pariwatcharakul, Pornjira, Petite, Joanne, Pfennig, Andrea, Ruiz, Yolanda Pica, Pinna, Marco, Pompili, Maurizio, Porter, Richard, Quiroz, Danilo, Rabelo-da-Ponte, Francisco Diego, Ramesar, Raj, Rasgon, Natalie, Ratta-Apha, Woraphat, Ratzenhofer, Michaela, Redahan, Maria, Reddy, M S, Reif, Andrea, Reininghaus, Eva Z, Richards, Jenny Gringer, Ritter, Philipp, Rybakowski, Janusz K, Sathyaputri, Leela, Scippa, Ângela M, Simhandl, Christian, Smith, Daniel, Smith, José, Stackhouse, Paul W, Stein, Dan J, Stilwell, Kellen, Strejilevich, Sergio, Su, Kuan-Pin, Subramaniam, Mythily, Sulaiman, Ahmad Hatim, Suominen, Kirsi, Tanra, Andi J, Tatebayashi, Yoshitaka, Teh, Wen Lin, Tondo, Leonardo, Torrent, Carla, Tuinstra, Daniel, Uchida, Takahito, Vaaler, Arne E, Vieta, Eduard, Viswanath, Biju, Yoldi-Negrete, Maria, Yalcinkaya, Oguz Kaan, Young, Allan H, Zgueb, Yosra, and Whybrow, Peter C

Subjects
Bipolar Disorder/complications, Male, Polarity, Bipolar disorder, Circadian rhythm, Depression, Psychiatry and Mental health, Clinical Psychology, Solar insolation, Sunlight, Humans, Female, Seasons
Abstract

OBJECTIVE: Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth.METHODS: Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer.RESULTS: The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001).CONCLUSION: Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.

Published
2022
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4. Association between solar insolation and a history of suicide attempts in bipolar I disorder

Author

Bharathram Sathur Raghuraman, Anton A. Mozzhegorov, Erkki Isometsä, Yosra Zgueb, Claire O'Donovan, Peter C. Whybrow, Rasmus Wentzer Licht, Eduard Vieta, Ingrid Melle, Sule Bicakci, Wendy K. Marsh, Julia Veeh, Rikke Krogh, Francisco Diego Rabelo da Ponte, John F. Gottlieb, Philipp Ritter, Fatima Meza-Urzua, Dan J. Stein, Mythily Subramaniam, Biju Viswanath, Ravi Kumar Nadella, Thomas Bjella, Marco Pinna, Kemal Sagduyu, Fabiano G. Nery, Kirsi Suominen, Hiromi Tagata, Mark A. Frye, Martin Alda, Mónica Martínez-Cengotitabengoa, Ole A. Andreassen, Mok Yee Ming, Chantal Henry, Michael Bauer, Scott Monteith, Elias Angelopoulos, Maurício Kunz, Ana González-Pinto, Erik Roj Larsen, Rodrigo A. Munoz, Frank Bellivier, Michael Berk, Mathias Kardell, Andrea Fagiolini, Mikael Landén, Janusz K. Rybakowski, Yavuz Ayhan, Ute Lewitzka, Sebastian Kliwicki, Starlin V. Mythri, Helle Østermark Sørensen, Robert H. Belmaker, Beny Lafer, Harriet Birabwa-Oketcho, Edgar Arrua Vares, Paul W. Stackhouse, Raffaella Ardau, Andreas Reif, René Ernst Nielsen, Jorge Cabrera, Sven Janno, Carlos López-Jaramillo, Ahmad Hatim Sulaiman, Fethi Nacef, Gunnar Morken, Kostas N. Fountoulakis, Arne E. Vaaler, Yoshitaka Tatebayashi, Tasha Glenn, Mirko Manchia, Barbara König, Rita Bauer, Raj Ramesar, Markus Donix, Bruno Etain, Mark Zetin, Danilo Quiroz, Yolanda Pica Ruiz, Slim Khaldi, Carla Torrent, Leonardo Tondo, Christopher Baethge, Sergio Strejilevich, Bernhard T. Baune, Enrica Mosca, Adel Omrani, Christian Simhandl, M. S. Reddy, Seetal Dodd, Maximilian Pilhatsch, Glenda MacQueen, Hirohiko Harima, Claudia Becerra-Palars, Flávio Kapczinski, Timur L. Kot, Paul Grof, Emanuel Severus, Yuly Bersudsky, Natalie L. Rasgon, Eric Yat Wo Cheung, Ângela Miranda Scippa, Maria Del Zompo, Yamima Osher, María Yoldi-Negrete, Uta Ouali, Department of Psychiatry, Clinicum, and HUS Psychiatry

Subjects
Male, Insolation, Internationality, Bipolar I disorder, RETINAL GANGLION-CELLS, MOOD DISORDERS, Substance-Related Disorders, Bipolar disorder, Climate, Seasonal variation, SEASONAL-VARIATION, Equator, Suicide, Attempted, 3124 Neurology and psychiatry, Latitude, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, medicine, Humans, Age of Onset, Solar insolation, Suicide, Sunlight, VITAMIN-D, SUBSTANCE USE, Biological Psychiatry, RISK, Suicide attempt, AGE-OF-ONSET, Age Factors, Middle Aged, Seasonality, medicine.disease, 030227 psychiatry, SHIFT WORK, Psychiatry and Mental health, Geography, Female, Seasons, CIRCADIAN-RHYTHMS, 030217 neurology & neurosurgery, BEHAVIOR, Demography
Abstract

In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p

Published
2019
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5. Solar insolation in springtime influences age of onset of bipolar I disorder

Author

Christian Simhandl, Harriet Birabwa-Oketcho, Slim Khaldi, Claire O'Donovan, Ahmad Hatim Sulaiman, Janusz K. Rybakowski, Dan J. Stein, M. S. Reddy, Rasmus Wentzer Licht, Andreas Reif, Flávio Kapczinski, Y. Pica Ruiz, Ângela Miranda Scippa, Christopher Baethge, Julia Veeh, M. Yee Ming, Kemal Sagduyu, Hiromi Tagata, Biju Viswanath, F. D. R. da Ponte, Scott Monteith, Michael Bauer, Mark A. Frye, Yamima Osher, Raffaella Ardau, Ana González-Pinto, Yoshitaka Tatebayashi, Chantal Henry, Sven Janno, M. A. Aleksandrovich, Timur L. Kot, Beny Lafer, Paul Grof, Yavuz Ayhan, René Ernst Nielsen, Barbara König, Eduard Vieta, Emanuel Severus, Erik Roj Larsen, Kirsi Suominen, Sebastian Kliwicki, Eric Yat Wo Cheung, Peter C. Whybrow, H. Østermark Sørensen, John F. Gottlieb, Mikael Landén, Michael Berk, Andrea Fagiolini, M. Del Zompo, Juan Cabrera, Carlos López-Jaramillo, Mirko Manchia, Tasha Glenn, Ingrid Melle, Starlin V. Mythri, Sule Bicakci, Rita Bauer, Maximilian Pilhatsch, Rodrigo A. Munoz, Danilo Quiroz, Glenda MacQueen, Philipp Ritter, Hirohiko Harima, Ravi Kumar Nadella, Enrica Mosca, Yuly Bersudsky, Natalie L. Rasgon, Wendy K. Marsh, Konstantinos N. Fountoulakis, María Yoldi-Negrete, Adel Omrani, Mathias Kardell, Fatima Meza-Urzua, Letizia Bossini, Fethi Nacef, Franck Bellivier, Erkki Isometsä, Gunnar Morken, Elias Angelopoulos, Marco Pinna, Thomas Bjella, Fabiano G. Nery, Sergio Strejilevich, Markus Donix, Bernhard T. Baune, Ole A. Andreassen, Leonardo Tondo, Rajkumar Ramesar, Claudia Becerra-Palars, Arne E. Vaaler, Yosra Zgueb, Uta Ouali, Seetal Dodd, Rikke Krogh, Ute Lewitzka, Maurício Kunz, S. R. Bharathram, Bruno Etain, Carla Torrent, Mythily Subramaniam, Robert H. Belmaker, Martin Alda, Mónica Martínez-Cengotitabengoa, Mark Zetin, Ben Hassine, AbdelHakim, University Hospital Carl Gustav Carus [Dresden, Germany], Technische Universität Dresden = Dresden University of Technology (TU Dresden), ChronoRecord Association Inc. [Fullerton, USA], Dalhousie University [Halifax], Soviet Psychoneurological Hospital [Urai, Russia], Norwegian Centre for Mental Disorders Research [Oslo] (NORMENT), University of Oslo (UiO)-Haukeland University Hospital, University of Bergen (UiB)-University of Bergen (UiB)-Oslo University Hospital [Oslo], University of Athens Medical School [Athens], Università degli Studi di Cagliari = University of Cagliari (UniCa), Faculty of Medicine [Hacettepe University], Hacettepe University = Hacettepe Üniversitesi, Faculty of Medicine [Cologne], University Hospital of Cologne [Cologne]-University of Cologne, National Institute of Mental Health and Neurosciences [Bangalore, Inde] (NIMHANS ), Adelaide Medical School [Australia], University of Adelaide, National Institute of Psychiatry Ramón de la Fuente Muñiz [Mexico City] (INPRF), Variabilité de réponse aux Psychotropes (VariaPsy - U1144), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Ben-Gurion University of the Negev (BGU), Deakin University [Burwood], University of Melbourne, Butabika Hospital [Kampala, Uganda], Università degli Studi di Siena = University of Siena (UNISI), Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Castle Peak Hospital [Hong Kong], Centre for Innovation in Mental and Physical Health and Clinical Treatment [Geelong Victoria, Australia] (IMPACT), Aristotle University of Thessaloniki, Mayo Clinic [Rochester], University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), Northwestern University Feinberg School of Medicine, Mood Disorders Center of Ottawa (MDCO), University of Ottawa [Ottawa], Kobe University, Tokyo Metropolitan Matsuzawa Hospital [Tokyo, Japan], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Perception et Mémoire / Perception and Memory, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), National Institute for Health and Welfare [Helsinki], Helsingin yliopisto = Helsingfors universitet = University of Helsinki, University of Tartu, Universidade Federal do Rio Grande do Sul [Porto Alegre] (UFRGS), Institute of Neuroscience and Physiology [Göteborg], Poznan University of Medical Sciences [Poland] (PUMS), BIPOLAR Zentrum Wiener Neustadt [Wiener Neustadt, Austria], Khanty-Mansiysk Clinical Psychoneurological Hospital [Khanty-Mansiysk, Russia], Aarhus University Hospital, Universidade de São Paulo Medical School (FMUSP), Karolinska Institutet [Stockholm], Aalborg University [Denmark] (AAU), Universidad de Antoquia, University of Calgary, University of Massachusetts Medical School [Worcester] (UMASS), University of Massachusetts System (UMASS), Institute of Mental Health [Singapore], Michigan State University [Traverse City], Michigan State University System, Department of Psychiatry [St. Olav's hospital, Trondheim], St. Olav's Hospital, Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), University of California [San Diego] (UC San Diego), University of California (UC), Asha Bipolar Clinic [Hyderabad, Telangana, India] (ABC), Université de Tunis El Manar (UTM), Faculté de Médecine de Tunis, Hospital Ángeles del Pedregal [Mexico City, Mexico], Centro Lucio Bini [Cagliari, Italy], Universidad Diego Portales [Santiago] (UDP), Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Stanford University School of Medicine [CA, USA], Goethe-Universität Frankfurt am Main, University of Missouri [Kansas City] (UMKC), University of Missouri System, Universidade Federal da Bahia (UFBA), Institute of Neuroscience Foundation Favaloro, Favaloro Foundation, Faculty of Medicine, University of Malaya [Kuala Lumpur, Malaisie], University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie] (UM), Tokyo Metropolitan Institute of Medical Science (TMIMS), McLean Hospital [Belmont, Ma.], University of Barcelona, Goethe-University Frankfurt am Main, Universitätsklinikum Frankfurt, Consejo Nacional de Ciencia y Tecnología [Mexico] (CONACYT), Chapman University, Semel Institute for Neuroscience and Human Behavior [Los Angeles, Ca], University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), Michael Berk is supported by an NHMRC Senior Principal Research Fellowship (1059660). Ole A Andreassen, Thomas DBjella and Ingrid Melle are supported by Research Council of Norway (223273) and KG Jebsen Stiftelsen. Ravi Nadella has received funding from the Accelerator program for Discovery in Brain disorders using Stem cells (ADBS), jointly funded by the Department of Biotechnology, Government of India, and the Pratiksha trust. Biju Viswanath has received funding by Department of Science and Technology INSPIRE scheme, Government of India. Mikael Landén was supported by grants from the Swedish Research Council (K2014‐62X‐14647‐12‐51 and K2010‐61P‐21568‐01‐4), the Swedish foundation for Strategic Research (KF10‐0039), and the Swedish Federal Government under the LUA/ALF agreement (ALF 20130032, ALFGBG‐142041)., We thank Haydeh Olofsson for valuable data management support., Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Tokyo Metropolitan Institute of Medical Science, Universita degli Studi di Cagliari [Cagliari], University of the Basque Country [Bizkaia] (UPV/EHU), University of Helsinki, University of California, University of Malaya [Kuala Lumpur, Malaisie], University of California-University of California, University of Cologne-University Hospital of Cologne [Cologne], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10

Subjects
Male, Internationality, Bipolar I disorder, Epidemiology, [SDV]Life Sciences [q-bio], 0302 clinical medicine, MESH: Asia/epidemiology, Age of Onset, Family history, First episode, MESH: Middle Aged, Circadian rhythm, Electromagnetic Radiation, MESH: Australia/epidemiology, Middle Aged, MESH: Seasons, 3. Good health, Europe, [SDV] Life Sciences [q-bio], MESH: Young Adult, Psychiatry and Mental Health, Solar insolation, Sunlight, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Seasons, Solar System, medicine.symptom, Mania, Adult, MESH: Sunlight, Asia, Adolescent, Bipolar disorder, MESH: Electromagnetic Radiation, MESH: Age of Onset, MESH: Solar System, MESH: Internationality, Young Adult, 03 medical and health sciences, MESH: Bipolar Disorder/epidemiology, MESH: South America/epidemiology, medicine, Journal Article, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH: Adolescent, MESH: Humans, business.industry, Australia, MESH: North America/epidemiology, MESH: Adult, South America, medicine.disease, MESH: Africa/epidemiology, MESH: Male, 030227 psychiatry, MESH: Europe/epidemiology, Mood disorders, 13. Climate action, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Africa, North America, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Age of onset, business, MESH: Female, 030217 neurology & neurosurgery, Demography
Abstract

OBJECTIVE: To confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder.METHOD: Data were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth-cohort, family history, polarity of first episode and country physician density.RESULTS: There was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth-cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth-cohort (all estimated coefficients P < 0.001).CONCLUSION: A large increase in springtime solar insolation may impact the onset of bipolar disorder, especially with a family history of mood disorders. Recent societal changes that affect light exposure (LED lighting, mobile devices backlit with LEDs) may influence adaptability to a springtime circadian challenge.

Published
2017
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