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Seasonal influences on first-episode admission in affective and non-affective psychosis

Published online by Cambridge University Press:  24 June 2014

Karen T Hallam*
Affiliation:
Mania Research Group, ORYGEN Youth Health Department of Psychiatry, The University of Melbourne, Parkville, Australia
Michael Berk
Affiliation:
Mania Research Group, ORYGEN Youth Health Department of Clinical and Biomedical Sciences, Barwon Health
Linda F. Kader
Affiliation:
Mania Research Group, ORYGEN Youth Health
Phillipe Conus
Affiliation:
Mania Research Group, ORYGEN Youth Health Department of Psychiatry, University of Lausanne, Lausanne, Switzerland
Nellie C. Lucas
Affiliation:
Mania Research Group, ORYGEN Youth Health Department of Psychiatry, The University of Melbourne, Parkville, Australia
Melissa Hasty
Affiliation:
Mania Research Group, ORYGEN Youth Health
Craig M. Macneil
Affiliation:
Mania Research Group, ORYGEN Youth Health
Patrick D. McGorry
Affiliation:
Mania Research Group, ORYGEN Youth Health
*
Karen T. Hallam, Mania Research Group, ORYGEN Youth Health, and Department of Psychiatry, The University of Melbourne, 35 Poplar Road, Parkville, Victoria 3052, Australia. Tel: +03 9342-2939; Fax: +03 9387 3003; E-mail: [email protected]

Abstract

Background:

Since bipolar affective disorder has been recorded, clinicians treating patients with this disorder have noted the cyclic nature of episodes, particularly an increase in mania in the spring and summer months and depression during winter.

Objective:

The aim of this study was to investigate seasonality in symptom onset and service admissions over a period of 10 years in a group of patients (n= 359) with first-episode (FE) mania (n= 133), FE schizoaffective disorder (n= 49) and FE schizophrenia (n= 177).

Method:

Patients were recruited if they were between 15 and 28 years of age and if they resided in the geographical mental health service catchment area. The number of patients experiencing symptom onset and service admission over each month and season was recorded.

Results:

In terms of seasonality of time of service admission, the results indicate a high overall seasonality (particularly in men), which was observed in both the schizoaffective and the bipolar groups. In terms of seasonality of symptom onset, the results indicate that seasonality remains in the male bipolar group, but other groups have no seasonal trend.

Conclusions:

This provides further evidence that systems mediating the entrainment of biological rhythms to the environment may be more pronounced in BPAD than in schizoaffective disorder and schizophrenia. These results may help facilitate the preparedness of mental heath services for patients at different times of the year.

Type
Research Article
Copyright
Copyright © 2006 Blackwell Munksgaard

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References

Goodwin, FK, Jamison, KR. Manic-depressive illness. New York: Oxford University Press, 1990. Google ScholarPubMed
Shapira, A, Shiloh, R, Potchter, O, Hermesh, H, Popper, M, Weizman, A. Admission rates of bipolar depressed patients increase during spring/summer and correlate with maximal environmental temperature. Bipolar Disord 2004;6:9093. CrossRefGoogle ScholarPubMed
Malhotra, S, Varma, VK, Misra, AK, Das, S, Wig, NN, Santosh, PJ. Onset of acute psychotic states in India: a study of sociodemographic, seasonal and biological factors. Acta Psychiatr Scand 1998;97:125131. CrossRefGoogle ScholarPubMed
Meesters, Y, Jansen, JHC, Beersma, DGM, Bouhuys, AL, Van den Hoofdakker, RH. Light therapy for seasonal affective disorder. Br J Psychiatry 1995;166:607612. CrossRefGoogle ScholarPubMed
Skwerer, RG, Jacobsen, FM, Duncan, CCet al. Neurobiology of seasonal affective disorder and phototherapy. J Biol Rhythms 1988;3:135154. CrossRefGoogle ScholarPubMed
Thompson, C, Stinson, D, Smith, A. Seasonal affective disorder and season-dependent abnormalities of melatonin suppression by light. Lancet 1990;336:703706. CrossRefGoogle Scholar
Timo, P, Lonnqvist, J. Seasonal affective disorder. Lancet 1998;352:13691374. Google Scholar
Wirz-Justice, A, Graw, P, Krauchi, Ket al. Light therapy in seasonal affective disorder is independent of time of day or circadian phase. Arch Gen Psychiatry 1993;50:929937. CrossRefGoogle ScholarPubMed
Nurnberger, JI Jr, Adkins, S, Lahiri, DKet al. Melatonin suppression by light in euthymic bipolar and unipolar patients. Arch Gen Psychiatry 2000;57:572579. CrossRefGoogle ScholarPubMed
Nathan, PJ, Burrows, GD, Norman, TR. Melatonin sensitivity to dim white light in affective disorders. Neuropsychopharmacology 1999;21:408413. CrossRefGoogle ScholarPubMed
Lewy, AJ, Nurnberger, JI Jr, Wehr, TAet al. Supersensitivity to light: possible trait marker for manic-depressive illness. Am J Psychiatry 1985;142:725727. Google ScholarPubMed
Lewy, AJ, Wehr, TA, Goodwin, FK, Newsome, DA. Manic-depressive patients may be supersensitive to light (Letter). Lancet 1981;1:383384. CrossRefGoogle Scholar
Wahlund, B, Saaf, J, Grahn, H, Wetterberg, L. Diagnostic subgrouping of depressed patients by principal component analysis and visualized pattern recognition. Psychiatry Res 1998;81:393401. CrossRefGoogle ScholarPubMed
Kennedy, SH, Kutcher, SP, Ralevski, E, Brown, GM. Nocturnal melatonin and 24h 6-sulfatoxymelatonin levels in various phases of bipolar affective disorder. Psychiatry Res 1996;63:219222. CrossRefGoogle Scholar
Brown, GM. Neuroendocrine probes as biological markers of affective disorders: new directions. Can J Psychiatry 1989;34:819823. CrossRefGoogle ScholarPubMed
Robertson, JM, Tanguay, PE. Case study: the use of melatonin in a boy with refractory bipolar disorder. J Am Acad Child Adolesc Psychiatry 1997;36:822825. CrossRefGoogle Scholar
Leibenluft, E, Feldman-Naim, S, Turner, EH, Schwartz, PJ, Wehr, TA. Salivary and plasma measures of dim light melatonin onset (DLMO) in patients with rapid cycling bipolar disorder. Biol Psychiatry 1996;40:731735. CrossRefGoogle ScholarPubMed
Wahlund, B, Grahn, H, Saaf, J, Wetterberg, L. Affective disorder subtyped by psychomotor symptoms, monoamine oxidase, melatonin and cortisol: identification of patients with latent bipolar disorder. Eur Arch Psychiatry Clin Neurosci 1998;248:215224. CrossRefGoogle ScholarPubMed
Hallam, KT, Olver, JS, Norman, TR. Melatonin sensitivity to light in monozygotic twins discordant for bipolar I disorder. Aust N Z J Psychiatry 2005;39:947. Google ScholarPubMed
Linkowski, P, Kerkhofs, M, Van Onderbergen, Aet al. The 24-hour profiles of cortisol, prolactin, and growth hormone secretion in mania. Arch Gen Psychiatry 1994;51:616624. CrossRefGoogle ScholarPubMed
Riemann, D, Voderholzer, U, Berger, M. Sleep and sleep-wake manipulations in bipolar depression. Neuropsychobiology 2002;45(Suppl. 1):712. CrossRefGoogle ScholarPubMed
Wehr, TA, Sack, DA, Rosenthal, NE. Sleep reduction as the final common pathway in the genesis of mania. Am J Psychiatry 1987;144:201204. Google ScholarPubMed
Wehr, TA. Effects of sleep and wakefulness in depression and mania. In: Montplaisir, J, Godbout, R, eds. Sleep and biological rhythms. London: Oxford University Press, 1990:4286. Google Scholar
Wehr, TA. Sleep loss: a preventable cause of mania and other excited states. J Clin Psychiatry 1989;50(Suppl.):816. Google ScholarPubMed
Columbo, C, Lucca, A, Benedetti, F, Barbini, B, Campori, E, Smeraldi, E. Total sleep deprivation combined with lithium and light therapy in the treatment of bipolar depression: replication of the main effects and interaction. Psychiatry Res 2000;95:4353. CrossRefGoogle Scholar
Wirz-Justice, A, Quinto, C, Cagochen, C, Werth, E, Hock, C. A rapid-cycling bipolar patient treated with long nights, bedrest and light. Biol Psychiatry 1999;45:10751077. CrossRefGoogle ScholarPubMed
Cassidy, F, Carroll, BJ. Seasonal variation of mixed and pure episodes of bipolar disorder. J Affect Disord 2002;68:2531. CrossRefGoogle ScholarPubMed
Frangos, E, Athanassenas, G, Tsitourides, Set al. Seasonality of the episodes or recurrent affective psychosis. Possibly prophylactic interventions. J Affect Disord 1980;2:239247. CrossRefGoogle ScholarPubMed
Clarke, M, Moran, P, Keogh, Fet al. Seasonal influences on admissions in schizophrenia and affective disorder in Ireland. Schizophr Res 1998;34:143149. CrossRefGoogle ScholarPubMed
Mulder, RT, Cosgriff, JP, Smith, AM, Joyce, PR. Seasonality of mania in New Zealand. Aust N Z J Psychiatry 1990;24:187190. CrossRefGoogle ScholarPubMed
Jones, I, Hornsby, H, Hay, D. Seasonality of mania: a Tasmanian study. Aust N Z J Psychiatry 1995;29:449453. CrossRefGoogle ScholarPubMed
Sayer, HK, Marshall, S, Mellsop, GW. Mania and seasonality in the southern hemisphere. J Affect Disord 1991;23:151156. CrossRefGoogle ScholarPubMed
Parker, G, Walter, S. Seasonal variation in depressive disorders and suicidal deaths in New South Wales. Br J Psychiatry 1982;140:626632. CrossRefGoogle ScholarPubMed
Daniels, BA, Kirkby, KC, Mitchell, P, Hay, D, Mowry, B. Seasonal variation in hospital admissions for bipolar disorder, depression and schizophrenia in Tasmania. Acta Psychiatr Scand 2000;102:3843. CrossRefGoogle ScholarPubMed
Silverstone, T, Romans, S, Hunt, N, McPherson, H. Is there a seasonal pattern of relapse in bipolar affective disorders? A dual northern and southern hemisphere cohort study. Br J Psychiatry 1995;167:5860. CrossRefGoogle Scholar
Faedda, GL, Tondo, L, Teicher, MHet al. Seasonal mood disorders: patterns of seasonal recurrence in mania and depression. Arch Gen Psychiatry 1993;50:1723. CrossRefGoogle ScholarPubMed
D’Mello, DA, McNeil, JA, Msibi, B. Seasons and bipolar disorder. Ann Clin Psychiatry 1995;7:1118. CrossRefGoogle ScholarPubMed
Takei, N, O’Callaghan, E, Sham, P, Glover, G, Tamura, A, Murray, R. Seasonality of admissions in the psychoses: effect of diagnosis, sex, and age at onset. Br J Psychiatry 1992;161:506511. CrossRefGoogle ScholarPubMed
Hare, EH, Walter, SD. Seasonal variation in admissions of psychiatric patients and its relation to seasonal variation in their births. J Epidemiol Community Health 1978;32:4752. CrossRefGoogle ScholarPubMed
Partonen, T, Lonnqvist, J. Seasonal variation in bipolar disorder. Br J Psychiatry 1996;169:641646. CrossRefGoogle ScholarPubMed
Clarke, M, Moran, P, Keogh, Fet al. Seasonal influences on admissions for affective disorder and schizophrenia in Ireland: a comparison of first and re-admissions. Eur Psychiatry 1999;14:251255. CrossRefGoogle Scholar
Strous, RD, Pollack, S, Robinson, D, Sheitman, B, Lieberman, JA. Seasonal admission patterns in first episode psychosis, chronic schizophrenia, and nonschizophrenic psychoses. J Nerv Ment Dis 2001;189:642644. CrossRefGoogle ScholarPubMed
Harris, MG, Henry, LP, Harrigan, SMet al. The relationship between duration of untreated psychosis and outcome: an eight-year prospective study. Schizophr Res 2005;79:8593. CrossRefGoogle Scholar
McGorry, PD, Singh, BS, Copolov, DL, Kaplan, I, Dossetor, CR, Van Riel, RJ. Royal Park Multidiagnostic Interview for Psychosis: part II. Development, reliability and validity. Schizophr Bull 1990;16:517536. CrossRefGoogle Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured clinical interview for DSM-IV-TR axis I disorders, research version, patient edition. New York: Biometrics Research, 2002. Google Scholar
Zanarini, MC, Skodol, AE, Bender, Det al. The collaborative longitudinal personality disorders study: reliability of axis I and II diagnoses. J Personal Disord 2000;14:291299. CrossRefGoogle ScholarPubMed
Jackson, HJ, McGorry, PD, Dudgeon, P. Prodromal symptoms of schizophrenia in first-episode psychosis: prevalence and specificity. Compr Psychiatry 1995;37:241250. CrossRefGoogle Scholar
Harrigan, SM, McGorry, PD, Krstev, H. Does treatment delay in first-episode psychosis really matter? Psychol Med 2003;33:97110. CrossRefGoogle ScholarPubMed
Owens, N, McGorry, PD. Seasonality of symptom onset in first-episode schizophrenia. Psychol Med 2003;33:163167. CrossRefGoogle ScholarPubMed
McGorry, PD, Hickie, IB, Yung, AR, Pantelis, C, Jackson, HJ. Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 2006;40:616622. CrossRefGoogle ScholarPubMed
Post, RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 1992;149:9991010. Google ScholarPubMed
Frank, E, Swartz, HA, Kupfer, DJ. Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder. Biol Psychiatry 2000;48:593604. CrossRefGoogle ScholarPubMed
Frank, E, Swartz, HA. Interpersonal and social rhythm therapy. In: Johnson, SL, Leahy, RL, eds. Psychological treatments of bipolar disorder. New York: Guilford Press, 2004:162183. Google ScholarPubMed
Miklowitz, DJ, Richards, JA, George, ELet al. Integrated family and individual therapy for bipolar disorder: results of a treatment development study. J Clin Psychiatry 2003;64:182191. CrossRefGoogle ScholarPubMed
Wirz-Justice, A. The effects of lithium on the circadian system. In: Lux, HD, Aldenhoff, JB, Emrich, HM, eds. Basic mechanisms in the action of lithium. Amsterdam, The Netherlands: Excerpta Medica, 1982:183192. Google Scholar
Hallam, KT, Olver, JS, Horgan, JE, McGrath, C, Norman, TR. Low doses of lithium carbonate reduce melatonin light sensitivity in healthy volunteers. Int J Neuropsychopharmacol 2005;8:255259. CrossRefGoogle ScholarPubMed
Harwood, AJ, Agam, G. Search for a common mechanism of mood stabilizers. Biochem Pharmacol 2003;66:179189. CrossRefGoogle ScholarPubMed
Iwahana, E, Akiyama, M, Miyakawa, Ket al. Effect of lithium on the circadian rhythms of locomotor activity and glycogen synthase kinase-3 protein expression in the mouse suprachiasmatic nuclei. Eur J Neurosci 2004;19:22812287. CrossRefGoogle ScholarPubMed
Jope, RS. Lithium and GSK-3: one inhibitor, two inhibitory actions, multiple outcomes. Trends Pharmacol Sci 2003;24:441443. CrossRefGoogle ScholarPubMed
Reppert, SM, Weaver, DR. Coordination of circadian timing in mammals. Nature 2002;418(6901):935941. CrossRefGoogle ScholarPubMed
Danion, JM, Canguilhem, B, Bentz, I, Imbs, JL, Chaillet, G. Long-term lithium treatment does not suppress hibernation in European hamsters. Neuropsychobiology 1990;23:3137. CrossRefGoogle Scholar
Kennaway, DJ, Rowe, SA. Melatonin binding sites and their role in seasonal reproduction. J Reprod Fertil 1995;49(Suppl.):423435. Google ScholarPubMed
Allain, D, Malpaux, B, Puechal, F, Thebault, RG, De Rochambeau, H, Chemineu, P. Genetic variability of the pattern of night melatonin blood levels in relation to coat changes development in rabbits. Genet Sel Evol 2004;36:207216. CrossRefGoogle ScholarPubMed