Relationship between sunlight and the age of onset of bipolar disorder: an international multisite study
Department of Psychiatry
Mental and Social Health | Mental Disorders | Psychiatry | Psychiatry and Psychology
BACKGROUND: The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode.
METHODS: Data from 4037 patients with bipolar I disorder were collected at 36 collection sites in 23 countries at latitudes spanning 3.2 north (N) to 63.4 N and 38.2 south (S) of the equator. The age of onset of the first episode, onset location, family history of mood disorders, and polarity of first episode were obtained retrospectively, from patient records and/or direct interview. Solar insolation data were obtained for the onset locations.
RESULTS: There was a large, significant inverse relationship between maximum monthly increase in solar insolation and age of onset, controlling for the country median age and the birth cohort. The effect was reduced by half if there was no family history. The maximum monthly increase in solar insolation occurred in springtime. The effect was one-third smaller for initial episodes of mania than depression. The largest maximum monthly increase in solar insolation occurred in northern latitudes such as Oslo, Norway, and warm and dry areas such as Los Angeles, California.
LIMITATIONS: Recall bias for onset and family history data.
CONCLUSIONS: A large springtime increase in sunlight may have an important influence on the onset of bipolar disorder, especially in those with a family history of mood disorders.
DOI of Published Version
J Affect Disord. 2014 Oct;167:104-11. doi: 10.1016/j.jad.2014.05.032 Link to article on publisher's site
Journal of affective disorders
Bauer M, Marsh WK. (2014). Relationship between sunlight and the age of onset of bipolar disorder: an international multisite study. Psychiatry Publications and Presentations. https://doi.org/10.1016/j.jad.2014.05.032. Retrieved from https://escholarship.umassmed.edu/psych_pp/667