Relapses in bipolar patients: changes in social rhythm?

Area of Science:

• Psychiatry
• Chronobiology
• Neuroscience

Background:

• Bipolar disorder (BD) is a mood disorder characterized by extreme mood swings.
• Changes in social rhythms can impact BD symptom stability.
• Ramadan fasting involves significant alterations in daily routines and social patterns.

Purpose of the Study:

• To investigate the effect of Ramadan-induced social rhythm changes on the mood state of bipolar patients.
• To monitor blood lithium levels in fasting bipolar patients during Ramadan.
• To assess relapse rates and side effects in bipolar patients observing Ramadan.

Main Methods:

• A pilot study involving 20 clinically stable bipolar patients on lithium therapy.
• Patients were assessed before, during, and after Ramadan using mood scales (Hamilton Depression, Bech-Rafaelsen) and lithium level measurements.
• Diagnosis of bipolar disorder followed ICD-10 criteria.

Main Results:

• 45% of bipolar patients relapsed during Ramadan, primarily with manic episodes (71.4%).
• Relapses occurred mainly in the second week of Ramadan and were not linked to lithium plasma concentrations.
• Increased lithium side effects (dry mouth, thirst, tremor) were noted in 48% of patients.

Conclusions:

• The Ramadan fasting period may disrupt the mood stability of bipolar patients.
• Further research is needed to confirm these findings and explore the Ramadan model for studying social rhythm impacts on bipolar disorder.
• Altered social rhythms during Ramadan pose a risk for bipolar disorder relapse.