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Disrupted circadian rhythm linked to mood disorders
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Disruption of normal daily circadian rhythms was associated with adverse mental health outcomes, including bipolar disorder and major depression, according to findings from a cross-sectional study in the United Kingdom.
“The integrity of circadian rhythmicity is crucial for mental health and well-being, and certain forms of disruption are associated with mood disorders, particularly major depressive disorder and bipolar disorder,” Laura M. Lyall, PhD, Institute of Health and Wellbeing, University of Glasgow, U.K., and colleagues wrote. “Although several studies have identified associations between disrupted circadian rhythmicity and adverse mental health outcomes, much of this work has limitations.”
Using accelerometer-based data from 91,105 U.K. Biobank participants aged 37 to 73 years, researchers assessed the associations between circadian rhythmicity and mental health and well-being outcomes, including history of mood disorder between 2013 and 2015.
The investigators collected data from a subset of participants who recorded their activity levels for 1 week with a wrist-worn accelerometer, deriving a circadian relative amplitude variable from the fitness-tracker to measure the extent to which circadian rhythmicity of rest–activity cycles were disturbed. Then, they examined associations in the sample between low relative amplitude and mood disorder, well-being and cognitive variables — lifetime MDD, lifetime bipolar disorder, mood instability, neuroticism, self-rated happiness, health satisfaction, loneliness and reaction time — using multiple regression models.
After adjusting for multiple covariates and confounders, Lyall and colleagues found lower circadian relative amplitude was linked to a higher likelihood of reporting lifetime history of MDD (adjusted OR = 1.06; 95% CI 1.04-1.08) and lifetime bipolar disorder (adjusted OR = 1.11; 95% CI, 1.03-1.2) in the sample. Furthermore, lower relative amplitude was also associated with greater mood instability (adjusted OR = 1.02; 95% CI, 1.01-1.04), higher neuroticism scores (IRR = 1·01; 95% CI, 1.01-1.02), more subjective loneliness (OR = 1.09; 95% CI, 1.07-1.11), lower happiness (OR = 0.91; 95% CI, 0.90-0.93), lower health satisfaction (OR = 0.90; 95% CI, 0.89-0.91) and lower reaction times.
“Overall, our findings suggest a reliable association between circadian disruption and both risk of mood disorders and worse subjective well-being outcomes,” the authors wrote in The Lancet Psychiatry.
“Our results also highlight the potential usefulness of accelerometry-derived relative amplitude as a marker of susceptibility to negative mental health and well-being outcomes,” they continued. “Relative amplitude is relatively cheaply and easily measured and might be useful for identifying people at greater risk of major depressive disorder or bipolar disorder, or subgroups of patients who might benefit from therapies aimed at improving circadian rhythmicity.”
However, the participants examined in Lyall and colleagues’ study were not the best representation to assess the causes of mental health considering many disorders originate before the age of 24 years, Aiden Doherty, senior research fellow at University of Oxford, wrote in a related commentary.
“As the authors note, the circadian system undergoes developmental changes during adolescence, which is also a common time for the onset of mood disorders,” Doherty wrote. “It might be that the U.K. Biobank provides the template and impetus for a resource of a similar scale in adolescents and younger adults to help transform our understanding of the causes and consequences, prevention, and treatment of mental health disorders.” – by Savannah Demko
Disclosures: Lyall reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures. Doherty reports no relevant financial disclosures.