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J Affect Disord. 2014;167:104-11. doi: 10.1016/j.jad.2014.05.032. Epub 2014 May 29.

Relationship between sunlight and the age of onset of bipolar disorder: an international multisite study.

Author information

1
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany. Electronic address: michael.bauer@uniklinikum-dresden.de.
2
ChronoRecord Association, Fullerton, CA, USA.
3
Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
4
NORMENT - K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, Oslo, Norway.
5
Department of Psychiatry, University of Athens Medical School, Eginition Hospital, Athens, Greece.
6
Unit of Clinical Pharmacology, University-Hospital of Cagliari, Sardinia, Italy.
7
Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany.
8
Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
9
Psychiatrie, GH Saint-Louis - Lariboisière - F. Widal, APHP, INSERM UMR-S1144, Faculté de Médecine, Université D. Diderot, Paris, France; FondaMental Fondation, Créteil, France.
10
Department of Psychiatry, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva Mental Health Center, Beer Sheva, Israel.
11
Deparment of Psychiatry, Diego Portales University, Santiago, Chile; Department of Psychiatry, ORYGEN Youth Health Research Centre, Centre for Youth Mental Health, Australia; The Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria 3052, Australia.
12
Department of Molecular Medicine and Department of Mental Health (DAI), University of Siena and University of Siena Medical Center (AOUS), Siena, Italy.
13
Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong.
14
Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy.
15
IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria 3220, Australia; Department of Psychiatry, University of Melbourne, Parkville, Victoria 3052, Australia.
16
AP-HP, Hopitaux Universitaires Henri Mondor and INSERM U955 (IMRB), Université Paris Est, Creteil, France; FondaMental Fondation, Créteil, France.
17
Department of Psychiatry & Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA.
18
3rd Department of Psychiatry, Division of Neurosciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
19
Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA.
20
Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain.
21
Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan.
22
Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.
23
Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
24
Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
25
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
26
BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria.
27
Department of Affective Disorders, Q, Mood Disorders Research Unit, Aarhus University Hospital, Denmark.
28
Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
29
Mood Disorders Program, Fundacion San Vicente de Paul, Department of Psychiatry, Universidad de Antioquia, Medellín, Colombia.
30
Department of Psychiatry, University of Massachusetts, Worcester, MA, USA.
31
Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA.
32
Department of Neuroscience, NTNU, and St Olavs' University Hospital, Trondheim, Norway.
33
Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
34
Deparment of Psychiatry, Diego Portales University, Santiago, Chile.
35
UCT/MRC Human Genetics Research Unit, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
36
Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
37
Department of Psychiatry, University of Missouri Kansas City, School of Medicine, Kansas City, MO, USA.
38
Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil.
39
Department of Psychiatry, University of Cape Town, Cape Town, South Africa.
40
Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina.
41
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
42
City of Helsinki, Department of Social Services and Health Care, Psychiatry, Helsinki, Finland.
43
Schizophrenia & Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Seatagaya, Tokyo, Japan.
44
Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
45
Department of Psychiatry, NIMHANS, Bangalore 560029, India.
46
Department of Psychology, Chapman University, Orange, CA, USA.
47
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA.

Abstract

BACKGROUND:

The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode.

METHODS:

Data from 4037 patients with bipolar I disorder were collected at 36 collection sites in 23 countries at latitudes spanning 3.2 north (N) to 63.4 N and 38.2 south (S) of the equator. The age of onset of the first episode, onset location, family history of mood disorders, and polarity of first episode were obtained retrospectively, from patient records and/or direct interview. Solar insolation data were obtained for the onset locations.

RESULTS:

There was a large, significant inverse relationship between maximum monthly increase in solar insolation and age of onset, controlling for the country median age and the birth cohort. The effect was reduced by half if there was no family history. The maximum monthly increase in solar insolation occurred in springtime. The effect was one-third smaller for initial episodes of mania than depression. The largest maximum monthly increase in solar insolation occurred in northern latitudes such as Oslo, Norway, and warm and dry areas such as Los Angeles, California.

LIMITATIONS:

Recall bias for onset and family history data.

CONCLUSIONS:

A large springtime increase in sunlight may have an important influence on the onset of bipolar disorder, especially in those with a family history of mood disorders.

KEYWORDS:

Age of onset; Bipolar disorder; Insolation; Sunlight

PMID:
24953482
DOI:
10.1016/j.jad.2014.05.032
[Indexed for MEDLINE]
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