Research paper
Sleep and circadian rhythms as possible trait markers of suicide attempt in bipolar disorders: An actigraphy study
V.Benard abc B.Etain defgh G.Vaivaabc C.Boudebesse d S.Yeim d C.Benizri d H.Brochard d
F.Bellivier defgh P.A.Geoffroy defgh
a Univ. Lille, CNRS, CHU Lille, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille F-59000, France
b Univ. Lille, CHRU Lille, Clinique de Psychiatrie, Unité CURE, Lille F-59000 France
c Univ. Lille, Hôpital Fontan CHRU Lille F-59000, France
d AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris cedex 10 75475, France
e Inserm, U1144, Paris F-75006, France
F.Bellivier defgh P.A.Geoffroy defgh
a Univ. Lille, CNRS, CHU Lille, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille F-59000, France
b Univ. Lille, CHRU Lille, Clinique de Psychiatrie, Unité CURE, Lille F-59000 France
c Univ. Lille, Hôpital Fontan CHRU Lille F-59000, France
d AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris cedex 10 75475, France
e Inserm, U1144, Paris F-75006, France
f Université Paris Descartes, UMR-S 1144, Paris F-75006, France
g Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
h Fondation FondaMental, Créteil 94000, France
Journal of Affective Disorders Volume 244, 1 February 2019, Pages 1-8
Background
The poor prognostic of Bipolar disorders (BD) is closely linked to deaths by suicide. Sleep and circadian abnormalities are observed during all phases of BD and are also associated with suicide attempt (SA). In this context, this study sought to identify specific sleep and circadian rhythms markers associated with suicidal attempt in euthymic patients with BD.
Methods The sample (N = 236) comprised 3 groups: 147 patients with BD including 57 with a history of SA and 90 without (NoSA), and 89 healthy controls (HC). All participants were recorded during 21 days with actigraphy.
Results SA was associated with women gender (p = 0.03), familial history of SA (p = 0.03), mixed episodes (p = 0.001), and benzodiazepines (p = 0.019). SA, compared to noSA, had a morning phase preference (p = 0.04), and were more vigorous on the circadian type inventory (p = 0.04), and tended to suffer more from insomnia (45% versus 25% respectively, p = 0.10). SA was also associated with an earlier onset of daily activity assessed with actigraphy (M10 onset: p = 0.01). Backward stepwise linear regression indicated that a combination of four variables (Gender, vigour, insomnia, M10onset) significantly differentiated patients with SA from NoSA (p = 0.03).
Limitations Cross-sectional design, and no examination of suicidal behaviors’ subgroups such as first attempters or repeaters, or violent suicide attempt.
Conclusions Woman gender, vigorous circadian type, insomnia and an earlier daily activity appeared independently associated with SA in BD. If these biomarkers are confirmed in prospective studies, they should be screened and used to prevent suicide, with the development of personal and targeted chronobiological treatments.
https://www.sciencedirect.com/science/article/pii/S0165032718310413
g Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
h Fondation FondaMental, Créteil 94000, France
Journal of Affective Disorders Volume 244, 1 February 2019, Pages 1-8
Background
The poor prognostic of Bipolar disorders (BD) is closely linked to deaths by suicide. Sleep and circadian abnormalities are observed during all phases of BD and are also associated with suicide attempt (SA). In this context, this study sought to identify specific sleep and circadian rhythms markers associated with suicidal attempt in euthymic patients with BD.
Methods The sample (N = 236) comprised 3 groups: 147 patients with BD including 57 with a history of SA and 90 without (NoSA), and 89 healthy controls (HC). All participants were recorded during 21 days with actigraphy.
Results SA was associated with women gender (p = 0.03), familial history of SA (p = 0.03), mixed episodes (p = 0.001), and benzodiazepines (p = 0.019). SA, compared to noSA, had a morning phase preference (p = 0.04), and were more vigorous on the circadian type inventory (p = 0.04), and tended to suffer more from insomnia (45% versus 25% respectively, p = 0.10). SA was also associated with an earlier onset of daily activity assessed with actigraphy (M10 onset: p = 0.01). Backward stepwise linear regression indicated that a combination of four variables (Gender, vigour, insomnia, M10onset) significantly differentiated patients with SA from NoSA (p = 0.03).
Limitations Cross-sectional design, and no examination of suicidal behaviors’ subgroups such as first attempters or repeaters, or violent suicide attempt.
Conclusions Woman gender, vigorous circadian type, insomnia and an earlier daily activity appeared independently associated with SA in BD. If these biomarkers are confirmed in prospective studies, they should be screened and used to prevent suicide, with the development of personal and targeted chronobiological treatments.
https://www.sciencedirect.com/science/article/pii/S0165032718310413
