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Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I disorder

2021; Springer Science+Business Media; Volume: 9; Issue: 1 Linguagem: Inglês

10.1186/s40345-021-00231-7

2194-7511

Michael Bauer, Tasha Glenn, Eric D. Achtyes, Martin Alda, Esen Ağaoğlu, Kürşat Altınbaş, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Edgar Arrua Vares, Memduha Aydın, Yavuz Ayhan, Christopher Baethge, Rita Bauer, Bernhard T. Baune, Ceylan Balaban, Claudia Becerra‐Palars, Aniruddh P. Behere, Prakash B. Behere, Habte Belete, Tilahun Belete, Gabriel Okawa Belizário, Frank Bellivier, Robert H. Belmaker, Francesco Benedetti, Michael Berk, Yuly Bersudsky, Şule Bıçakcı, Harriet Birabwa-Oketcho, Thomas Bjella, Conan Brady, Jorge Cabrera, Marco Cappucciati, Angela Marianne Paredes Castro, Wei-Ling Chen, Eric Yat Wo Cheung, S. Chiesa, Marie Crowe, Alessandro Cuomo, Sara Dallaspezia, Maria Del Zompo, Pratikkumar Desai, Seetal Dodd, Markus Donix, Bruno Étain, Andrea Fagiolini, Frederike T. Fellendorf, Ewa Ferensztajn‐Rochowiak, Jess G. Fiedorowicz, Konstantinos Ν. Fountoulakis, Mark A. Frye, Pierre A. Geoffroy, Ana González‐Pinto, John F. Gottlieb, Paul Grof, Bartholomeus C. M. Haarman, Hirohiko Harima, Mathias Hasse-Sousa, Chantal Henry, Lone Høffding, Josselin Houenou, Massimiliano Imbesi, Erkki Isometsä, Maja Ivković, Sven Janno, Simon Johnsen, Flávio Kapczinski, Grigorios N. Karakatsoulis, Mathias Kardell, Lars Vedel Kessing, Seong Jae Kim, Barbara König, Timur L. Kot, Michael Koval, Maurício Kunz, Beny Lafer, Mikael Landén, Erik Roj Larsen, Melanie Lenger, Ute Lewitzka, Rasmus Wentzer Licht, Carlos López‐Jaramillo, Alan Mackenzie, Helle Østergaard Madsen, Simone Alberte Kongstad A. Madsen, Jayant Mahadevan, Agustine Mahardika, Mirko Manchia, Wendy Marsh, Mónica Martínez‐Cengotitabengoa, Klaus Martiny, Yuki Mashima, Declan M. McLoughlin, Ybe Meesters, Ingrid Melle, Fátima Meza-Urzúa, Mok Yee Ming, Scott Monteith, Muthukumaran Moorthy, Gunnar Morken, Enrica Mosca, Anton A. Mozzhegorov, Rodrigo Muñoz, Starlin Vijay Mythri, F. Nacef, Ravi Kumar Nadella, Takako Nakanotani, René Ernst Nielsen, Claire O’Donovan, Adel Omrani, Yamima Osher, Uta Ouali, Maja Pantović-Stefanović, Pornjira Pariwatcharakul, Joanne Petite, Andrea Pfennig, Yolanda Pica Ruiz, Maximilian Pilhatsch, Marco Pinna, Maurizio Pompili, Richard Porter, Danilo Quiroz, Francisco Diego Rabelo-da-Ponte, Raj Ramesar, Natalie Rasgon, Woraphat Ratta‐apha, Michaela Ratzenhofer, Maria Redahan, M. S. Reddy, Andreas Reif, Eva Z. Reininghaus, Jenny Gringer Richards, Philipp Ritter, Janusz Rybakowski, Leela Sathyaputri, Ângela Miranda Scippa, Christian Simhandl, Emanuel Severus, Daniel J. Smıth, José Smith, Paul W. Stackhouse, Dan J. Stein, Kellen Stilwell, Sergio Strejilevich, Kuan‐Pin Su, Mythily Subramaniam, Ahmad Hatim Sulaiman, Kirsi Suominen, Andi J. Tanra, Yoshitaka Tatebayashi, Wen Lin Teh, Leonardo Tondo, Carla Torrent, Daniel Tuinstra, Takahito Uchida, Arne E. Vaaler, Julia Veeh, Eduard Vieta, Biju Viswanath, María Yoldi‐Negrete, Oğuz Kaan Yalçınkaya, Allan H. Young, Yosra Zgueb, Peter C. Whybrow,

Psychological and Temporal Perspectives Research

Abstract Background Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.