Chronotype preferences in bipolar disorder patients with and without attention deficit-hyperactivity disorder: A comparative study with the healthy control group

OBJECTIVE: Epidemiological, neuroimaging and family studies highlight a possible relationship between bipolar disorder and attention deficit hyperactivity disorder. Disturbances in circadian rhythm are seen in both bipolar disorder and attention deficit-hyperactivity disorder, and chronotype preferences are mostly in favor of evening wear. Our aim in this study is to examine the effects of attention deficit hyperactivity disorder comorbidity and subtypes on chronotype preferences in patients with bipolar disorder and to compare the factors that may be related with the healthy control group. METHODS: The study included 74 patients who were diagnosed with bipolar disorder in Aydın Adnan Menderes University Hospital and were treated as an outpatient in the outpatient clinic, accepted to participate in the study and met the inclusion criteria. In the healthy control group, 56 people from Aydın Adnan Menderes University Hospital staff and Aydın Adnan Menderes University Faculty of Medicine students who met the criteria for participation were included. Sociodemographic data of all participants were taken in detail and SCID-I, YMDÖ, HAM-D, HAM-A, DIVA-2.0 were applied by the clinician. In addition, participants with a diagnosis of bipolar disorder will fill in the ASRS, WURS, MEQ and PUKI scales; PUKI and MEQ scales were applied to healthy controls. RESULTS: When we compared the healthy control group and the bipolar disorder group in terms of chronotype preferences, no statistically significant difference was found between the two groups. When the three groups we included in the study were compared in terms of morningness/eveningness scores, there was a significant difference between the three groups. Adding a comorbid diagnosis of attention deficit hyperactivity disorder to patients with bipolar disorder caused a decrease in morningness/eveningnessscores and a shift in evening chronotype preferences. In the analysis performed after controlling the participant age, duration of education, HAM-D, HAM-A and YMDÖ scores, ASRS Total score, ASRS hyperactivity/impulsivity scores, which were found to be significantly associated with morningness/eveningness score in our study, morningness/eveningness score and BD disease duration were determined. A significant correlation was found between ASRS inattention score and PUKI total score. CONCLUSION: Our study, in which we investigated the effect of attention deficit hyperactivity disorder comorbidity on the chronotype preferences of patients with bipolar disorder and the factors that may be related, has not been conducted before, according to our knowledge. According to the results of the study, the addition of a comorbid diagnosis of attention deficit hyperactivity disorder to patients with bipolar disorder causes an increase in alcohol, substance and cigarette use, a shift in chronotype preferences towards evening, and a further deterioration in sleep parameters. Especially the inattention dimension of attention deficit hyperactivity disorder predicts eveningness in patients with BD. KEYWORDS: Bipolar Disorder,Attention Deficit-Hyperactivity Disorder,Chronotype