J Korean Neuropsychiatr Assoc.  2018 Nov;57(4):276-286. 10.4306/jknpa.2018.57.4.276.

Is the Circadian Rhythm Dysregulation a Core Pathogenetic Mechanism of Bipolar Disorder?

• Lee HJ

• KMID: 2426856
• DOI: http://doi.org/10.4306/jknpa.2018.57.4.276

Abstract

Circadian rhythm is a periodic and continuous change in physiological, behavioral, and mental characteristics that occurs in most organisms on the Earth, because the Earth rotates in a 24-hour cycle. The circadian system regulates daily rhythms of physiology and behavior, such as the sleep/wake cycle, body temperature, hormonal secretion, and mood. The influence of circadian rhythm is very powerful, but limited research has addressed its effects. However, many recent studies have shown that circadian dysregulation may play an important role in the pathogenesis of bipolar disorder. This review study examined current and noteworthy studies, including the authors' own works, and proposes a possible clinical application of bipolar disorder based on evidence that circadian rhythm dysregulation in bipolar disorder may be a key pathogenetic mechanism.

Keyword

Bipolar disorder; Circadian rhythm; Pathogenetic mechanism

MeSH Terms

Bipolar Disorder*
Body Temperature
Chronobiology Disorders
Circadian Rhythm*
Physiology

Figure

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  Fig. 1 Normal circadian rhythm of various physiology and behaviors in human.

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  Fig. 2 Phase response curve to light.

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  Fig. 3 Phase response curve to melatonin.

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  Fig. 4 Delay of a normal phase of mood circadian rhythm may induce a depressive period before noon, representing so called diurnal mood variation in depression.

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  Fig. 5 The circadian misalignment hypothesis for the depressive, mixed, manic, and hypomanic episodes.

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