Exploratory study of ultraviolet B (UVB) radiation and age of onset of bipolar disorder

Bauer M 1 , Glenn T 2 , Achtyes ED 3 , Alda M 4 , Agaoglu E 5 , Altınbaş K 6 Show all authors , Andreassen OA 7 , Angelopoulos E 8 , Ardau R 9 , Aydin M 10 , Ayhan Y 5 , Baethge C 11 , Bauer R 12 , Baune BT 13 , Balaban C 14 , Becerra-Palars C 15 , Behere AP 16 , Behere PB 17 , Belete H 18 , Belete T 18 , Belizario GO 19 , Bellivier F 20 , Belmaker RH 21 , Benedetti F 22 , Berk M 23 , Bersudsky Y 24 , Bicakci Ş 5 , Birabwa-Oketcho H 25 , Bjella TD 7 , Brady C 26 , Cabrera J 27 , Cappucciati M 28 , Castro AMP 23 , Chen WL 29 , Cheung EYW 30 , Chiesa S 28 , Crowe M 31 , Cuomo A 32 , Dallaspezia S 33 , Del Zompo M 9 , Desai P 3 , Dodd S 23 , Etain B 20 , Fagiolini A 32 , Fellendorf FT 34 , Ferensztajn-Rochowiak E 35 , Fiedorowicz JG 36 , Fountoulakis KN 37 , Frye MA 38 , Geoffroy PA 39 , Gitlin MJ 40 , Gonzalez-Pinto A 41 , Gottlieb JF 42 , Grof P 43 , Haarman BCM 44 , Harima H 45 , Hasse-Sousa M 46 , Henry C 47 , Hoffding L 48 , Houenou J 49 , Imbesi M 28 , Isometsä ET 50 , Ivkovic M 51 , Janno S 52 , Johnsen S 53 , Kapczinski F 46 , Karakatsoulis GN 37 , Kardell M 54 , Kessing LV 55 , Kim SJ 56 , König B 57 , Kot TL 58 , Koval M 59 , Kunz M 46 , Lafer B 19 , Landén M 54 , Larsen ER 60 , Lenger M 34 , Licht RW 61 , Lopez-Jaramillo C 62 , MacKenzie A 63 , Madsen HØ 64 , Madsen SAKA 53 , Mahadevan J 65 , Mahardika A 66 , Manchia M 67 , Marsh W 68 , Martinez-Cengotitabengoa M 69 , Martini J 12 , Martiny K 64 , Mashima Y 70 , McLoughlin DM 71 , Meesters Y 44 , Melle I 7 , Meza-Urzúa F 72 , Mikolas P 12 , Mok YM 73 , Monteith S 74 , Moorthy M 65 , Morken G 75 , Mosca E 9 , Mozzhegorov AA 76 , Munoz R 77 , Mythri SV 78 , Nacef F 79 , Nadella RK 65 , Nakanotani T 80 , Nielsen RE 61 , O'Donovan C 4 , Omrani A 81 , Osher Y 24 , Ouali U 79 , Pantovic-Stefanovic M 51 , Pariwatcharakul P 82 , Petite J 4 , Petzold J 12 , Pfennig A 12 , Ruiz YP 83 , Pinna M 84 , Pompili M 85 , Porter RJ 31 , Quiroz D 86 , Rabelo-da-Ponte FD 87 , Ramesar R 88 , Rasgon N 89 , Ratta-Apha W 82 , Ratzenhofer M 34 , Redahan M 26 , Reddy MS 90 , Reif A 14 , Reininghaus EZ 34 , Richards JG 91 , Ritter P 12 , Rybakowski JK 35 , Sathyaputri L 91 , Scippa AM 92 , Simhandl C 93 , Smith D 94 , Smith J 95 , Stackhouse PW 96 , Stein DJ 97 , Stilwell K 3 , Strejilevich S 95 , Su KP 98 , Subramaniam M 99 , Sulaiman AH 100 , Suominen K 101 , Tanra AJ 102 , Tatebayashi Y 80 , Teh WL 99 , Tondo L 103 , Torrent C 104 , Tuinstra D 3 , Uchida T 70 , Vaaler AE 75 , Vieta E 104 , Viswanath B 65 , Yoldi-Negrete M 105 , Yalcinkaya OK 5 , Young AH 106 , Zgueb Y 79 , Whybrow PC 40

Affiliations 

  • 1 Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. michael.bauer@uniklinikum-dresden.de
  • 2 ChronoRecord Association, Fullerton, CA, USA
  • 3 Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA
  • 4 Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
  • 5 Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
  • 6 Department of Psychiatry, Selcuk University Faculty of Medicine, Mazhar Osman Mood Center, Konya, Turkey
  • 7 NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  • 8 Department of Psychiatry, National and Capodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
  • 9 Section of Neurosciences and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Sardinia, Italy
  • 10 Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
  • 11 Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
  • 12 Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
  • 13 Department of Psychiatry, University of Münster, Münster, Germany
  • 14 Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Johann Wolfgang Goethe-Universität Frankfurt Am Main, Frankfurt Am Main, Germany
  • 15 National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico
  • 16 Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI, USA
  • 17 Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, India
  • 18 Department of Psychiatry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
  • 19 Bipolar Disorder Research Program, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
  • 20 Département de Psychiatrie et de Médecine Addictologique, Assistance Publique, Hôpitaux de Paris, INSERM UMR-S1144, Université Paris Cité, Fondation FondaMental, Paris, France
  • 21 Division of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
  • 22 University Vita-Salute San Raffaele, Milan, Italy
  • 23 IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
  • 24 Department of Psychiatry, Faculty of Health Sciences, Beer Sheva Mental Health Center, Ben Gurion University of the Negev, Beer Sheva, Israel
  • 25 Butabika Hospital, Kampala, Uganda
  • 26 Department of Psychiatry, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
  • 27 Mood Disorders Clinic, Dr. Jose Horwitz Psychiatric Institute, Santiago de Chile, Chile
  • 28 Department of Mental Health and Substance Abuse, Piacenza, Italy
  • 29 Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan
  • 30 Private Practice, Central, Hong Kong, China
  • 31 Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
  • 32 Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy
  • 33 Psychiatry and Clinical Psychobiology, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
  • 34 Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
  • 35 Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
  • 36 Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada
  • 37 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • 38 Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
  • 39 Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat, Claude Bernard, 75018, Paris, France
  • 40 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
  • 41 BIOARABA, Department of Psychiatry, University Hospital of Alava, University of the Basque Country, CIBERSAM, Vitoria, Spain
  • 42 Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
  • 43 Mood Disorders Center of Ottawa and the Department of Psychiatry, University of Toronto, Toronto, Canada
  • 44 Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  • 45 Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya, Tokyo, Japan
  • 46 Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
  • 47 Department of Psychiatry, GHU Paris Psychiatrie and Neurosciences, Université de Paris, F-75014, F-75006, Paris, France
  • 48 Department of Clinical Research, University of Southern Denmark, Odense, Denmark
  • 49 Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, APHP, Mondor Univ Hospitals, Fondation FondaMental, F-94010, Créteil, France
  • 50 Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  • 51 Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
  • 52 Department of Psychiatry, University of Tartu, Tartu, Estonia
  • 53 Unit for Psychiatric Research, Aalborg University Hospital, Aalborg, Denmark
  • 54 Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  • 55 Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Center Copenhagen, Copenhagen, Denmark
  • 56 Department of Psychiatry, Chosun University School of Medicine, Gwangju, Republic of Korea
  • 57 BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
  • 58 Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
  • 59 Neuroscience Program, Michigan State University, East Lansing, MI, USA
  • 60 Mental Health Department Odense, University Clinic and Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
  • 61 Psychiatry, Aalborg University Hospital, Aalborg, Denmark
  • 62 Mood Disorders Program, Hospital Universitario San Vicente Fundación, Research Group in Psychiatry, Department of Psychiatry, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia
  • 63 Forensic Psychiatry, University of Glasgow, NHS Greater Glasgow and Clyde, Glasgow, UK
  • 64 Psychiatric Centre Copenhagen, Copenhagen University Hospitals, Copenhagen, Denmark
  • 65 Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
  • 66 Department of Psychiatry, Faculty of Medicine, Mataram University, Mataram, Indonesia
  • 67 Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
  • 68 Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
  • 69 Osakidetza, Basque Health Service, BioAraba Health Research Institute, University of the Basque Country, Bilbao, Spain
  • 70 Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
  • 71 Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
  • 72 Department of Child and Adolescent Psychiatry Und Psychotherapy, SHG Klinikum, Idar-Oberstein, Germany
  • 73 Department of Mood and Anxiety Disorders, Institute of Mental Health, Singapore City, Singapore
  • 74 Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
  • 75 Department of Mental Health, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
  • 76 Soviet Psychoneurological Hospital, Urai, Russia
  • 77 Department of Psychiatry, University of California San Diego, San Diego, CA, USA
  • 78 Makunda Christian Leprosy and General Hospital, Bazaricherra, Assam, 788727, India
  • 79 Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
  • 80 Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-Ku, Tokyo, 150-0013, Japan
  • 81 Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
  • 82 Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 83 Hospital "Ángeles del Pedregal", Mexico City, Mexico
  • 84 Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
  • 85 Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
  • 86 Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
  • 87 School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, UK
  • 88 SA MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute of Infectious Diseases and Molecular, Medicine, University of Cape Town, Cape Town, South Africa
  • 89 Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
  • 90 Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
  • 91 Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
  • 92 Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
  • 93 Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
  • 94 Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
  • 95 AREA, Assistance and Research in Affective Disorders, Buenos Aires, Argentina
  • 96 Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
  • 97 Department of Psychiatry, MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
  • 98 College of Medicine, China Medical University (CMU), Taichung, Taiwan
  • 99 Research Division, Institute of Mental Health, Singapore, Singapore
  • 100 Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 101 Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
  • 102 Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • 103 McLean Hospital-Harvard Medical School, Boston, MA, USA
  • 104 Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
  • 105 Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
  • 106 Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Int J Bipolar Disord, 2023 Jun 22;11(1):22.
PMID: 37347392 DOI: 10.1186/s40345-023-00303-w

Abstract

BACKGROUND: Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample.

METHODS: Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001.

RESULTS: The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger.

CONCLUSION: UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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