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Chronobiol Int. 2017;34(7):845-854. doi: 10.1080/07420528.2017.1324472. Epub 2017 May 24.

Seasonal pattern in bipolar disorders and cardio-vascular risk factors: A study from the FACE-BD cohort.

Geoffroy PA1,2,3,4, Godin O4,5,6,7, Mahee D1, Henry C4,5,8,9, Aubin V4,10, Azorin JM4,11, Bougerol T4,12, Courtet P4,13, Gard S4,14, Kahn JP4,15, Passerieux C4,16, Leboyer M4,5,8,17, Bellivier F1,2,3,4, Etain B1,2,3,4; FACE-BD coll.

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a AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique , Paris , France.
b Université Paris Diderot , Sorbonne Paris Cité , Paris , France.
c Inserm, U1144 , Paris , France.
d Fondation FondaMental , Créteil , France.
e Inserm, U955, Equipe Psychiatrie Translationnelle , Créteil , France.
f Sorbonne Universités, Université Pierre et Marie Curie, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136) , Paris , France.
g INSERM, UMR_S 1136 , F-75013 Paris , France.
h Université Paris Est, Faculté de Médecine , Créteil , France.
j Institut Pasteur, Unité Perception et Mémoire , Paris , France.
k Service de psychiatrie, Centre hospitalier Princesse-Grace , Avenue Pasteur , Monaco.
l Pôle de psychiatrie, Hôpital Sainte Marguerite, Assistance Publique Hôpitaux de Marseille, France; Aix-Marseille Université, CNRS , CRN2M UMR 7286 , Marseille , France.
m Clinique Universitaire de Psychiatrie, CHU de Grenoble , Grenoble , France.
n Département d'Urgence et Post Urgence Psychiatrique , CHRU Montpellier, INSERM U1061, Université Montpellier 1 , Montpellier , France.
o Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale Universitaire, Centre Hospitalier Charles Perrens , Bordeaux , France.
p Université de Lorraine, CHRU de Nancy et Pôle 6 de Psychiatrie et Psychologie Clinique - Centre Psychothérapique de Nancy , 1 rue du Docteur Archambault, Laxou Cedex , France.
q Université de Versailles Saint-Quentin, Centre Hospitalier de Versailles, Service de Psychiatrie Adulte , Le Chesnay , France.
i AP-HP, Hôpitaux Universitaires Henri Mondor, DHU Pepsy, Pôle de Psychiatrie et d'Addictologie , Créteil , France.


Seasonal pattern (SP) and metabolic syndrome (MetS) are major contributors to poor outcome in bipolar disorders (BD). Patients with seasonal bipolar depression present increased appetite, carbohydrate cravings, weight gain, and hypersomnia, which can increase the development of MetS. MetS also appears to be associated with seasonal mood changes in the general population. This study examines whether a SP in BD is associated with an increased risk of MetS and its sub-components. One thousand four hundred and seventy-one outpatients with BD were systematically enrolled from 2009 to 2016. Inclusion required a disease duration of at least 5 years, with 486 (33%) patients with SP (SP+) and 985 (67%) without (SP-) according to the DSM IV-TR criteria. When using continuous measures of metabolic components, SP+ patients, as compared to SP-, suffered from higher levels for systolic blood pressure (p = 0.01), low-density lipoprotein cholesterol (p = 0.009), fasting glucose (p = 0.007), triglycerides levels (p = 0.03), a larger abdominal circumference (p = 0.02), and a higher body mass index (p = 0.07). In the covariance analysis, adjusted for gender, age, and bipolar subtype, as well as the number of depressive and hypomanic episode, SP+ patients had a significantly higher level of fasting glucose and higher systolic blood pressure. The frequency of MetS did not differ between groups (21.2% in SP- versus 23.9% in SP+). When using categorical definitions for abnormal metabolic components (International Diabetes Federation criteria), there were no differences between groups, except that SP+ patients were more overweight/obese as compared to SP- patients (55.03% versus 46.7%, respectively; p = 0.002) and tended to have more frequently high fasting glucose (18.2% versus 14.3%, respectively; p = 0.07). MetS was frequent in patients with BD, however not associated with SP. Patients with SP appeared more vulnerable to overweight/obesity and presented with higher levels of MetS subcomponents although these parameters were mainly in the normal range. All patients with BD should benefit from early screening and targeted management of cardio-vascular risk factors.


Bipolar disorder; circadian rhythms; depression; metabolic syndrome; seasonal affective disorder

[Indexed for MEDLINE]

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