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Variations in seasonal solar insolation are associated with a history of suicide attempts in bipolar I 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 , Vares EA 10 , Aydin M 11 , Ayhan Y 5 , Baethge C 12 , Bauer R 10 , 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 34 , Dodd S 23 , Donix M 10 , Etain B 20 , Fagiolini A 32 , Fellendorf FT 35 , Ferensztajn-Rochowiak E 36 , Fiedorowicz JG 37 , Fountoulakis KN 38 , Frye MA 39 , Geoffroy PA 40 , Gonzalez-Pinto A 41 , Gottlieb JF 42 , Grof P 43 , Haarman BCM 44 , Harima H 45 , Hasse-Sousa M 46 , Henry C 47 , Høffding 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 38 , 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 35 , Lewitzka U 10 , 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 , Martiny K 64 , Mashima Y 70 , McLoughlin DM 71 , Meesters Y 44 , Melle I 7 , Meza-Urzúa F 15 , Ming MY 72 , Monteith S 73 , Moorthy M 65 , Morken G 74 , Mosca E 9 , Mozzhegorov AA 75 , Munoz R 76 , Mythri SV 77 , Nacef F 78 , Nadella RK 65 , Nakanotani T 79 , Nielsen RE 61 , O'Donovan C 4 , Omrani A 80 , Osher Y 24 , Ouali U 78 , Pantovic-Stefanovic M 51 , Pariwatcharakul P 81 , Petite J 4 , Pfennig A 10 , Ruiz YP 82 , Pilhatsch M 10 , Pinna M 83 , Pompili M 84 , Porter R 31 , Quiroz D 85 , Rabelo-da-Ponte FD 46 , Ramesar R 86 , Rasgon N 87 , Ratta-Apha W 81 , Ratzenhofer M 35 , Redahan M 26 , Reddy MS 77 , Reif A 14 , Reininghaus EZ 35 , Richards JG 88 , Ritter P 10 , Rybakowski JK 36 , Sathyaputri L 88 , Scippa ÂM 89 , Simhandl C 90 , Severus E 10 , Smith D 91 , Smith J 92 , Stackhouse PW 93 , Stein DJ 94 , Stilwell K 34 , Strejilevich S 92 , Su KP 95 , Subramaniam M 96 , Sulaiman AH 97 , Suominen K 98 , Tanra AJ 99 , Tatebayashi Y 79 , Teh WL 96 , Tondo L 100 , Torrent C 101 , Tuinstra D 34 , Uchida T 70 , Vaaler AE 74 , Veeh J 14 , Vieta E 101 , Viswanath B 65 , Yoldi-Negrete M 102 , Yalcinkaya OK 5 , Young AH 103 , Zgueb Y 78 , Whybrow PC 104

Affiliations 

  • 1 Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, 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 and Psychotherapy, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
  • 11 Department of Psychiatry, Selcuk University Faculty of Medicine, Konya, Turkey
  • 12 Department of Psychiatry and Psychotherapy, University of Cologne Medical School, Cologne, Germany
  • 13 Department of Psychiatry, University of Münster, Munster, 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 Child and Adolescent Psychiatry, Helen DeVos Children's Hospital, Michigan State University-CHM, 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 de Paris, FondaMental Foundation, Paris, France
  • 21 Professor Emeritus of Psychiatry, Ben Gurion University of the Negev, Beer Sheva, Israel
  • 22 University Vita-Salute San Raffaele, Milan, Italy
  • 23 Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, 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
  • 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 Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
  • 35 Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Graz, Austria
  • 36 Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
  • 37 Department of Psychiatry, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
  • 38 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • 39 Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, Rochester, MN, USA
  • 40 Département de Psychiatrie et d'addictologie, AP-HP, Hopital Bichat-Claude Bernard, Paris, France
  • 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, Ottawa, 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 & Neurosciences, 75014, Paris, France
  • 48 Department of Clinical Research, University of Southern Denmark, Odense, Denmark
  • 49 Université Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, 94010, Créteil, France
  • 50 Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
  • 51 University Clinical Center of Serbia, Clinic for Psychiatry, 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, Rigshospitalet, Copenhagen, Denmark
  • 56 Department of Psychiatry, Cheongju Hospital, Cheongju, South Korea
  • 57 BIPOLAR Zentrum Wiener Neustadt, Wiener Neustadt, Austria
  • 58 Khanty-Mansiysk Clinical Psychoneurological Hospital, Khanty-Mansiysk, Russia
  • 59 Department of Neuroscience, 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 Copenhagen University Hospitals, Psychiatric Centre Copenhagen, 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 Research Institute, University of the Basque Country, Vitoria, Spain
  • 70 Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
  • 71 Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College Dublin, St Patrick's University Hospital, Dublin, Ireland
  • 72 Department of General Psychiatry, Mood Disorders Unit, Institute of Mental Health, Singapore City, Singapore
  • 73 Michigan State University College of Human Medicine, Traverse City Campus, Traverse City, MI, USA
  • 74 Department of Mental Health, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
  • 75 Soviet Psychoneurological Hospital, Urai, Russia
  • 76 Department of Psychiatry, University of California San Diego, San Diego, CA, USA
  • 77 Asha Bipolar Clinic, Asha Hospital, Hyderabad, Telangana, India
  • 78 Razi Hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia
  • 79 Affective Disorders Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya, Tokyo, Japan
  • 80 Tunisian Bipolar Forum, Érable Médical Cabinet 324, Lac 2, Tunis, Tunisia
  • 81 Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 82 Hospital "Ángeles del Pedregal", Mexico City, Mexico
  • 83 Section of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
  • 84 Department of Neurosciences, Mental Health and Sensory Organs, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
  • 85 Deparment of Psychiatry, Diego Portales University, Santiago de Chile, Chile
  • 86 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
  • 87 Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, CA, USA
  • 88 Departments of Psychiatry, Epidemiology, and Internal Medicine, Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
  • 89 Department of Neuroscience and Mental Health, Federal University of Bahia, Salvador, Brazil
  • 90 Bipolar Zentrum Wiener Neustadt, Sigmund Freud Privat Universität, Vienna, Austria
  • 91 Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
  • 92 Bipolar Disorder Program, Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
  • 93 Science Directorate/Climate Science Branch, NASA Langley Research Center, Hampton, VA, USA
  • 94 Department of Psychiatry, MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
  • 95 College of Medicine, China Medical University (CMU), Taichung, Taiwan
  • 96 Research Division, Institute of Mental Health, Singapore, Singapore
  • 97 Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 98 Department of Social Services and Health Care, Psychiatry, City of Helsinki, Helsinki, Finland
  • 99 Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • 100 McLean Hospital-Harvard Medical School, Boston, MA, USA
  • 101 Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
  • 102 Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Mexico City, Mexico
  • 103 Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
  • 104 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles (UCLA), Los Angeles, CA, USA
Int J Bipolar Disord, 2021 Sep 01;9(1):26.
PMID: 34467430 DOI: 10.1186/s40345-021-00231-7

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 

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

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