Sleep and Circadian Dysregulation in Pediatric Bipolar Disorder

小儿双相情感障碍的睡眠和昼夜节律失调

• 批准号: 9249974
• 负责人: Anda Gershon
• 金额: $ 18.07万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9249974
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Attention deficit hyperactivity disorder; Bipolar Disorder; Child; Childhood; Circadian Dysregulation; Circadian Rhythms; Clinical; Clinical Research; Control Groups; Coupling; Data; Dependence; Development; Diagnosis; Dimensions; Disease; Environment; Exhibits; Fostering; Functional disorder; Home environment; Incidence; Intervention; Investigation; Knowledge; Laboratories; Life; Link; Literature; Manic; Measures; Mental Depression; Mentored Research Scientist Development Award; Mentorship; Monitor; Mood Disorders; Moods; Nature; Outcome; Parents; Patient Self-Report; Pattern; Phase; Polysomnography; Population; Psychopathology; Publications; Questionnaires; Reporting; Research; Research Personnel; Research Project Grants; Risk; Role; Sampling; Series; Severities; Sleep; Sleep Architecture; Sleep Disorders; Sleep Fragmentations; Social Interaction; Stress; Testing; Time; Training; Universities; Youth; actigraphy; base; career; childhood bipolar disorder; density; early detection biomarkers; high risk; improved; non rapid eye movement; novel; novel marker; outcome forecast; prevent; programs; public health relevance; reduce symptoms; research study; sleep onset; social; training project; virtual

DESCRIPTION (provided by applicant): The purpose of this K01 Mentored Research Scientist Development Award application is to facilitate my training in the field of sleep and pediatric bipolar disorder (PBD) and in so doing, support my short-term objectives to: (1) comprehensively characterize sleep and circadian rhythms in adolescents with bipolar disorder (BD), and (2) investigate the relationship between sleep/circadian dysregulation and mood dysregulation in this population. The proposed training and research project represent the key first step in laying the groundwork for a long-term independent, academic, clinical research career focused on sleep and circadian dysregulation in the onset, development, course, and treatment of pediatric mood disorders. Multiple lines of evidence suggest that sleep/circadian disruptions are core features of adult BD, and that these disruptions may trigger episodes of illness. However, there is virtually no information on the nature and severity of sleep/circadian disruption in PBD, or on the potential contribution of sleep/circadian disruption to mood dysregulation. Given incidence rates of BD peak during adolescence and that BD is associated with particularly devastating outcomes when onset is early in life, adolescence offers a critical window for understanding the development of this disorder. Previous studies assessing sleep and circadian functioning in PBD samples have largely relied on subjective measures. The proposed research study will be the first to use a comprehensive, ecologically sensitive, and objective characterization of sleep/circadian rhythms in adolescents with BD relative to controls. This assessment combines two nights of ambulatory polysomnography (PSG), along with a two- week observation period of continuous actigraphy, and daily monitoring of subjective sleep, social rhythms, and affect. Daily measures of social interaction, stress, and rumination will also be collected. By investigating sleep in bipolar youth, the proposed study aims to address a gap in knowledge on the role of sleep and circadian disruption in the early development and progression of PBD. The hypotheses predict group differences in: (H1a) sleep architecture, specifically sleep efficiency, REM latency, and REM density and duration; (H1b) sleep and wake durations, sleep fragmentation, and daytime activity level; (H1c) overall rates of sleep disorders; (H1d) subjective sleep measures and regularity of social rhythms. The proposed investigation will also examine a potential link between daily sleep and daily affect in order to test for group differences in (H2) the degree of sleep-affect coupling. The proposed integrated program of research, mentorship and didactic training, combined with the outstanding research environment at Stanford University will foster my long-term career objective to be an independent investigator of sleep and circadian mechanisms in pediatric mood disorders.

描述（由申请人提供）：这个K01指导研究科学家发展奖申请的目的是促进我在睡眠和儿科双相情感障碍（PBD）领域的培训，并在此过程中，支持我的短期目标：(1)全面表征青少年双相情感障碍（BD）的睡眠和昼夜节律，(2)调查这一人群中睡眠/昼夜节律失调和情绪失调之间的关系。该培训和研究项目是为儿童情绪障碍的发生、发展、过程和治疗中睡眠和昼夜节律失调的长期独立学术临床研究生涯奠定基础的关键的第一步。多项证据表明，睡眠/昼夜节律中断是成人双相障碍的核心特征，这些中断可能引发疾病发作。然而，几乎没有关于PBD中睡眠/昼夜节律中断的性质和严重程度的信息，也没有关于睡眠/昼夜节律中断对情绪失调的潜在贡献的信息。鉴于双相障碍的发病率在青春期达到高峰，而且当双相障碍在生命早期发病时，其后果尤其严重，因此青春期为理解这种疾病的发展提供了一个关键的窗口期。先前评估PBD样本睡眠和昼夜节律功能的研究在很大程度上依赖于主观测量。这项拟议的研究将是第一个对双相障碍青少年患者的睡眠/昼夜节律进行全面、生态敏感和客观表征的研究。这项评估结合了两晚的动态多导睡眠描记术（PSG），以及两周的连续活动描记术观察期，以及对主观睡眠、社会节律和情绪的日常监测。日常社会互动、压力和沉思的测量也将被收集。通过调查双相青少年的睡眠，本研究旨在解决睡眠和昼夜节律紊乱在PBD早期发展和进展中的作用。这些假设预测了组间的差异：（H1a）睡眠结构，特别是睡眠效率、REM潜伏期、REM密度和持续时间；（H1b）睡眠和清醒持续时间、睡眠碎片和日间活动水平；（H1c）睡眠障碍的总体发生率；

项目成果

Differential prevalence and demographic and clinical correlates of antidepressant use in American bipolar I versus bipolar II disorder patients.

美国 I 型双相情感障碍患者与 II 型双相情感障碍患者抗抑郁药物使用的差异患病率以及人口统计学和临床​​相关性。

• DOI: 10.1016/j.jad.2018.02.091
• 发表时间: 2018
• 期刊: Journal of affective disorders
• 影响因子: 6.6
• 作者: Hooshmand,Farnaz;Do,Dennis;Shah,Saloni;Gershon,Anda;Park,DongYeon;Kim,Hyun;Yuen,LauraD;Dell'Osso,Bernardo;Wang,PoW;Ketter,TerenceA;Miller,Shefali
• 通讯作者: Miller,Shefali

Is energy a stronger indicator of mood for those with bipolar disorder compared to those without bipolar disorder?

与没有双相情感障碍的人相比，对于双相情感障碍患者来说，能量是否是更强的情绪指标？

• DOI: 10.1016/j.psychres.2015.06.016
• 发表时间: 2015
• 期刊: Psychiatry research
• 影响因子: 11.3
• 作者: Johnson,SheriL;Gershon,Anda;Starov,Vladimir
• 通讯作者: Starov,Vladimir