Bipolar Disorder, Circadian Rhythm and Clock Genes
Junsoo Chung1,*, Young-Chan Kim1,2,*, Jong-Hyun Jeong1,2
1Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Jong-Hyun Jeong
Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea
E-mail: anton3@catholic.ac.kr
ORCID: https://orcid.org/0000-0003-3570-7607

*These authors contributed equally to this work.
Received: April 18, 2023; Revised: May 17, 2023; Accepted: May 24, 2023; Published online: July 17, 2023.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Sleep disturbance and abnormal circadian rhythm might be closely related to bipolar disorder. Several studies involving disturbed sleep/wake cycle, changes in rhythms such as melatonin and cortisol, clock genes, and circadian preference have shown the relationship between bipolar disorder and circadian rhythm. The results differed across different studies. In some studies, a delay in the circadian rhythm was observed in the depressive episode and advanced circadian rhythm was observed during the manic episode. In other studies, a delay in circadian rhythm was observed independent of mood episodes. Accordingly, circadian rhythm disorder was proposed as a trait marker for bipolar disorder. The altered circadian rhythm may represent a pathological mechanism that contributes to the mood episodes. However, a prospective cohort study is needed for further clarification.
Keywords: Bipolar disorder; Circadian rhythm; Clock genes; Sleep

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