Social Rhythm Research Articles

Telehealth Social Rhythm Therapy to Reduce Mood Symptoms and Suicide Risk Among Adolescents and Young Adults With Bipolar Disorder.

Social rhythm irregularities are associated with increased bipolar disorder symptoms and suicide risk. This study was the first to examine the feasibility and acceptability of a 12-week social rhythm therapy (SRT) delivered predominantly via telehealth (three in-person sessions, nine via video teleconferencing) to adolescents and young adults with bipolar disorder. The primary aim was to determine the feasibility and acceptability of SRT delivered predominantly via telehealth. Secondary aims were to explore the intervention's impacts on social rhythm regularity, mood symptoms, and suicide propensity. Thirteen adolescents and young adults with bipolar disorder received a modified SRT called Brain Emotion circuitry-targeted Self-Monitoring And Regulation Therapy for Daily Rhythms (BE-SMART-DR) administered mostly remotely, adjunctive to treatment as usual. Retention rates, client satisfaction, therapeutic alliance, and pre- to postintervention changes in social rhythm regularity, mood symptoms, and suicide propensity were assessed. BE-SMART-DR was associated with high retention rates (77%), high mean±SD scores on the Client Satisfaction Questionnaire (29.4±2.7), and high participant global scores on the Working Alliance Inventory (231.3±8.1), indicative of strong therapeutic alliance. Secondary outcome measures on social rhythm irregularities, mood symptoms, and suicide propensity decreased from pre- to posttherapy. Increased social rhythm regularity was associated with reduced suicide propensity after analyses were controlled for reductions in mood symptoms. These preliminary results indicate that SRT delivered largely by telemedicine is feasible and acceptable. The intervention appeared to reduce mood symptoms, and suicide propensity independent of mood symptoms, among adolescents and young adults with bipolar disorder.

Détection et intervention précoce auprès des jeunes avec trouble bipolaire émergent : où en sommes-nous ?

Bipolar disorder (BD) is one of the most disabling chronic illness for which the delay in diagnosis and access to adequate care is about 10 years, with many consequences such as numerous comorbidities, greater illness severity and resistance to treatments. Building on advances in early intervention in psychosis, optimizing the detection of patients with BD and intervening early is essential to improve their prognosis. Identifying risk factors for BD would allow earlier detection of the target population with the aims of: (1) preventing the development of the disease, (2) delaying its onset and (3) improving the course through more timely treatment. We conducted a narrative review of the literature of the past 30 years on risk factors of BD and synthetising the concepts of at-risk of BD mental state, the staging model and associated interventions. These concepts are illustrated by a clinical case with and without early intervention highlighting the challenges of early intervention in BD and the scientific data currently available of use to the clinician (both general practitioners and psychiatrist). In addition to genetic and environmental risk factors (early trauma, substance use, etc.), vulnerability markers (cyclothymic or hyperthymic temperament, cluster B personality disorder) can guide the clinician towards the detection of at risk of BD mental state syndrome consisting of attenuated symptoms of hypomania, mood lability, early depressive episode with psychotic, severe or atypical characteristics. The delay in access to care attributable to the absence of “help-seeking”, to self-stigmatization, or to unrecognized diagnoses (misdiagnosis with personality disorders or substance use disorders) weighs down the prognosis leading, as episodes cumulate over time, to incomplete remission of episodes with residual symptoms and significant functional decline. The use of validated tools and careful coordination of the various actors are assets for the early identification of subjects at-risk of transition to BD. Following the staging model, targeted primary prevention interventions (e.g., promotion of good sleep hygiene, stress management strategies) for at-risk individuals should be offered by general practitioner or other front-line mental health professionals (e.g., psychologist, nurse); early secondary prevention (for stage 1) should be provided by general psychiatric or general medicine services. Although no official guidelines for early intervention for BD are available yet, experts opinions are multiplying and supporting an integrated approach that maximizes young patient engagement. These integrated approaches aiming at symptomatic and functional improvement combine effective psychopharmacology and psychosocial interventions, including cognitive- behavioral therapy, approaches based on social rhythm, psychoeducation, relapse prevention, social and vocational recovery and family interventions. The scarcity of studies on the early stages of bipolar disorder limits the predictive value of risk factors and at-risk syndromes which remain to be validated. Prospective controlled studies are warranted to improve the prevention efforts and effective early treatment of bipolar disorder.

Monitoring beliefs and physiological measures in students at risk for COVID-19 using wearable sensors and smartphone technology: Protocol for a mobile health study.

BackgroundThe COVID-19 pandemic has significantly impacted lives and greatly affected the mental health and public safety of an already vulnerable population—college students. Social distancing and isolation measures have presented challenges to students’ mental health. mHealth apps and wearable sensors may help monitor students at risk of COVID-19 and support their mental well-being.ObjectiveThis study aimed to monitor students at risk of COVID-19 by using a wearable sensor and a smartphone-based survey.MethodsWe conducted a prospective study on undergraduate and graduate students at a public university in the Midwest United States. Students were instructed to download the Fitbit, Social Rhythms, and Roadmap 2.0 apps onto their personal smartphone devices (Android or iOS). Subjects consented to provide up to 10 saliva samples during the study period. Surveys were administered through the Roadmap 2.0 app at five timepoints: at baseline, 1 month later, 2 months later, 3 months later, and at study completion. The surveys gathered information regarding demographics, COVID-19 diagnoses and symptoms, and mental health resilience, with the aim of documenting the impact of COVID-19 on the college student population.ResultsThis study enrolled 2158 college students between September 2020 and January 2021. Subjects are currently being followed-up for 1 academic year. Data collection and analysis are currently underway.ConclusionsThis study examined student health and well-being during the COVID-19 pandemic and assessed the feasibility of using a wearable sensor and a survey in a college student population, which may inform the role of our mHealth tools in assessing student health and well-being. Finally, using data derived from a wearable sensor, biospecimen collection, and self-reported COVID-19 diagnosis, our results may provide key data toward the development of a model for the early prediction and detection of COVID-19.Trial RegistrationClinicalTrials.gov NCT04766788; https://clinicaltrials.gov/ct2/show/NCT04766788International Registered Report Identifier (IRRID)DERR1-10.2196/29561

Effect of the lockdown on diurnal patterns of emotion expression in Twitter

ABSTRACT Diurnal variation in psychometric indicators of emotion found in Twitter content has been known for many years. The degree to which this pattern depends upon different environmental zeitgebers has been difficult to determine. The nationwide lockdown in the United Kingdom in spring 2020 provided a unique government-mandated experiment to observe the temporal variation of psychometric indicators in the absence of certain specific social rhythms related to commuting and workplace social activities as well as many normal home-based social activities. We therefore analyzed the aggregated Twitter content of 54 UK cities in the 9 weeks of complete lockdown, comparing them with the 10 weeks that preceded them (as well as with the corresponding weeks of 2019). We observed that the key indicators of emotion retained their diurnal behavior. This suggests that even during lockdown there are still sufficient zeitgebers to maintain this diurnal variation in indicators of emotion.

Disrupted rhythms of life, work and entertainment and their associations with psychological impacts under the stress of the COVID-19 pandemic: A survey in 5854 Chinese people with different sociodemographic backgrounds.

The coronavirus disease 2019 (COVID-19) pandemic has affected the life and work of people worldwide. The present study aimed to evaluate the rhythm disruptions of life, work, and entertainment, and their associations with the psychological impacts during the initial phase of the COVID-19 pandemic. A cross-sectional study was conducted from the 10th to 17th March 2020 in China. A structured e-questionnaire containing general information, the Chinese version of Brief Social Rhythm Scale, and Zung's self-rating scales of depression and anxiety (SDS and SAS) was posted and collected online through a public media (i.e. EQxiu online questionnaire platform). Scores in sleeping, getting up, and socializing (SGS) rhythm and eating, physical practice, and entertainment (EPE) rhythm were compared among and between participants with different sociodemographic backgrounds including gender, age, education, current occupation, annual income, health status, and chronic disease status. Correlations of SDS and SAS with SGS-scale and EPE-scale were also analyzed. Overall, 5854 participants were included. There were significant differences in the scores of SGS-scale and EPE-scale among people with different sociodemographic backgrounds. The scores were significantly higher in the groups with female gender, low education level, lower or higher than average income, poor health status, ages of 26-30 years or older than 61 years, nurses and subjects with divorce or widow status. There were also significant differences in SAS and SDS scores among people with different sociodemographic backgrounds (all P< 0.05). The overall prevalence of depression and anxiety was 24.3% and 12.6%, respectively, with nurses having the highest rates of depression (32.94%) and anxiety (18.98%) among the different occupational groups. SGS-scale was moderately correlated with SDS and SAS, and disruption of SGS rhythm was an independent risk factor for depression and anxiety. Social rhythm disruption was independently associated with depression and anxiety. Interventions should be applied to people vulnerable to the rhythm disruption during the COVID-19 pandemic.

Reward Sensitivity and Social Rhythm Disruption During Goal-Striving: A Phase-Temporal Approach to Ecological Momentary Assessment Data

The integrative Reward/Circadian Rhythm (RCR) model suggests that when individuals with hypersensitive reward systems encounter reward-relevant life events (i.e., engage in goal-striving), they experience increased social rhythm disruption (SRD), which triggers mood symptoms. This study tests elements of this hypothesis using an ecological momentary assessment (EMA) design.

Research on the Construction of Class Culture from the Perspective of Employment Orientation

With the popularity of the Internet, colleges have become an important gathering place of multi culture. With the acceleration of social rhythm, employment oriented talent training has become an important indicator in college teaching, which requires colleges to continuously enhance employment orientation (hereinafter referred to as EO) in daily teaching. At the same time, with the school enterprise joint education in full swing, it has become an important index for colleges to cultivate and transport professional talents for enterprises, which requires colleges to establish a learning atmosphere based on EO. The construction of class culture (hereinafter referred to as CC) is an important basis for the construction of campus culture, which requires us to constantly integrate CC and EO, which will better meet the needs of colleges for skilled talents. Through the integration of employment culture and CC, colleges can build employment oriented CC, which will achieve the training objectives of colleges. CC construction can realize ideological and political education (hereinafter referred to as IAPE). First, this paper analyzes the importance of building employment oriented CC. Then, this paper puts forward some problems. Finally, some suggestions are put forward.

Social rhythms and occupational functioning disturbance in remitted bipolar patients

IntroductionBiological rhythm disturbance is etiologically involved in mood disorders. Previous literature focused on studying sleep disruption in bipolar disorders (BD). However, only a few studies addressed the influence of social rhythms and occupational functioning as they may affect circadian regularity and consequently be a critical pathway to mood symptoms.ObjectivesThe main aim of this study was to assess biological rhythms in remitted bipolar patients and to evaluate their social rhythms and occupational functioning.MethodsWe recruited a total of 80 euthymic outpatients with BD and 80 control subjects. Biological rhythm disruptions were assessed using the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN), an interviewer administered questionnaire that assesses disruptions in sleep, eating patterns, social rhythms, and general activity.ResultsPatients with BD experienced greater biological rhythm alterations than the control group (BRIAN total scores 35.26±9.21 vs. 25.84±2.68). In addition to their sleep-wake rhythm (mean scores 11.1±3.95 vs. 7.41±1.41), patients were particularly more impaired than the control group with regards to social rhythms (7.31 ± 2.57 vs. 5.24 ± 1.06) and general activity (8.9 ± 3.35 vs. 7.01 ± 1.4).ConclusionsOur study indicated that patients with BD experience major disruptions in their social rhythms and occupational functioning. These alterations may lead to unstable biological rhythms and to a higher risk of mood episodes. Therefore, consolidating social rhythms and functioning appears to be a crucial step for preventing relapses in patients with BD.DisclosureNo significant relationships.

Impact of the COVID-19 pandemic and the lockdown period on the number of hospitalizations for acute mania

IntroductionCOVID-19 pandemic has affected social interaction and healthcare worldwide especially during the period of lockdown. As a result of this pandemic in Tunisia, the activity of hospital services and all non-emergency acts, in several specialties have been reduced. In psychiatry, such measures have not been taken. In the social zeitgeber hypothesis social rhythm disrupting life events such as eating, activity, and social patterns, may lead to the onset of manic episodes.ObjectivesThe objective of this study was to evaluate the impact of the COVID-19 pandemic on the frequency of acute mania in the context of bipolar disorder during the lockdown and post lockdown period compared to the same period during last year in a psychiatric department in Tunisia.MethodsWe assessed the number of hospitalizations in our department for acute mania in the context of bipolar disorder during the lockdown period in our country, (from March 1st and May 30, 2020) and during the two months following it. We compared this frequency to that of the previous year during the same periods.ResultsDuring the lockdown period, 17 patients were hospitalized for acute mania in the context of bipolar disorder. Sixty-seven patients were hospitalized in 2019 during the same period for acute mania. Nine hospitalizations for acute mania in the post lockdown period (between June and July 2020), were noted compared to 16 hospitalizations in the same period in 2019.ConclusionsLockdown seemed to have a protective effect from affective episodes in bipolar disorder. Perceiving increased connectedness among families may explain these findings.

The Rhythm is Gonna Get You: Social Rhythms, Sleep, Depressive, and Anxiety Symptoms

BackgroundSocial rhythmicity refers to the regularity with which one engages in social and lifestyle activities. Social rhythms have important implications for health and well-being including the prevention and treatment of mental health disorders. Existing research on social rhythmicity has focused on the link with bipolar disorder and, to a lesser extent, with depression. However, it is unclear how social rhythms are tied to anxiety disorders or what might mediate this association. Sleep shows potential as an underlying link, particularly sleep behaviors and sleep thoughts. MethodsThe current study used a sample of 3,284 adults to examine the role of sleep thoughts and behaviors as mediators of the association between social rhythms and mental health symptoms of depression and anxiety. ResultsParallel mediation models revealed that greater social rhythmicity is directly associated with fewer depressive and anxiety symptoms, and that healthier sleep behaviors and thoughts mediate this association. LimitationsThis study used cross-sectional data and was limited in racial and ethnic diversity. ConclusionsThe findings highlight the critical role lifestyle regularity plays in depressive and anxious symptom pathology in a large sample of adults across the lifespan. Results also highlight the complementary roles for both sleep behaviors and thoughts by demonstrating their concurrent links between regularity and mental health. Future work is needed to further disentangle the association of these constructs with mental health.

Living With Bipolar Disorder in the Time of Covid-19: Biorhythms During the Severe Lockdown in Cagliari, Italy, and the Moderate Lockdown in Tunis, Tunisia.

Background: Restrictions during Covid-19 pandemic lockdown, in which rhythms of life have been compromised, can influence the course of bipolar disorder (BD). This study follows patients with bipolar disorder living in two geographically close cities (Cagliari and Tunis), but with different lockdown conditions: less severe in Tunis.Methods: Two cohorts were evaluated during lockdown (April 2020, t0) and 2 months later with lockdown lifted for a month (t1). Individuals were: over 18 years old without gender exclusion, BD I or II, in care for at least 1 year, received a clinical interview in the month before the start of the lockdown, stable clinically before the lockdown. The assessment was conducted by telephone by a psychiatrist or psychologist with good knowledge of patients. Diagnoses were made according to DSM-5 criteria. Depressive symptoms were collected through the Hamilton Rating Scale for Depression; cut-off 14 indicative of depressive episode. Circadian rhythms were measured using the BRIAN scale.Results: Forty individuals in Cagliari (70%female, age 48.57 ± 11.64) and 30 in Tunis (53.3% Female, age 41.8 ± 13.22) were recruited. In Cagliari at t0 45% had depressive episodes against none in Tunis, a similar difference appeared at t1. At t0 and t1 the Cagliari sample had more dysfunctional scores in the overall BRIAN scale and in the areas of sleep, activities and social rhythms; no differences were found in nutrition, both samples had predominantly nocturnal rhythm. In Cagliari at t0 and t1, the depressive sub-group showed more dysfunctional scores in the BRIAN areas sleep, activity, and nutrition. However, the differences in biological rhythms resulted, through ANCOVA analysis, independent of the co-presence of depressive symptoms.Discussion: A rigid lockdown could expose people with BD to depressive relapse through dysregulation of biological rhythms. The return to more functional rhythms did not appear 1 month after lockdown. The rekindling of the pandemic and the restoration of new restrictive measures will prevent, at least in the short term, the beneficial effect of a return to normality of the two cohorts.This was a limited exploratory study; future studies with larger samples and longer observational time are needed to verify the hypothesis.

Inconsistent social rhythms are associated with abdominal adiposity after involuntary job loss: An observational study.

ObjectiveUnemployment is an established risk factor for obesity. However, few studies have examined obesity‐related health behavior after involuntary job loss specifically. Job loss confers a disruption in daily time structure that could lead to negative metabolic and psychological outcomes through chronobiological mechanisms. This study examines whether individuals with unstable social rhythms after involuntary job loss present with higher abdominal adiposity than individuals with more consistent social rhythms and whether this relationship varies as a function of depressive symptoms.MethodsCross‐sectional baseline data (n = 191) from the ongoing Assessing Daily Activity Patterns in occupational Transitions (ADAPT) study were analyzed using linear regression techniques. Participants completed the Social Rhythm Metric‐17 (SRM) daily over 2 weeks. They also completed the Beck Depression Inventory II (BDI‐II) and participated in standardized waist circumference measurements (cm).ResultsA significant interaction emerged between SRM and BDI‐II demonstrating that less consistent social rhythms were associated with larger waist circumference at lower levels of depressive symptoms. Additional exploratory analyses demonstrated a positive association between the number of daily activities performed alone and waist circumference when controlling for symptoms of depression.ConclusionThese findings are the first to demonstrate a relationship between social rhythm stability and abdominal adiposity in adults who have recently, involuntarily lost their jobs. Results highlight the moderating role of depressive symptoms on daily routine in studies of metabolic health. Future prospective analysis is necessary to examine causal pathways.

Application of Interpersonal and Social Rhythm Therapy (IPSRT) for Depression Associated With Schizophrenia Spectrum Disorders.

People with schizophrenia spectrum disorders frequently experience depression, yet depressive symptoms are often unaddressed. The authors propose that interpersonal and social rhythm therapy (IPSRT) may be effective for individuals with these disorders who experience depression. IPSRT is a manualized, evidence-based treatment for bipolar disorders. It combines the core elements of interpersonal psychotherapy for unipolar depression with social rhythm therapy to target disrupted social rhythms. The authors highlight evidence for the potential utility of IPSRT to treat patients with schizophrenia spectrum disorders and present a case example. IPSRT is one promising therapy that could fill a treatment gap for people with schizophrenia spectrum disorders by addressing depressive symptoms. Future work should build on this rationale and case example to design and implement a randomized controlled trial of IPSRT for treatment of schizophrenia spectrum disorders and evaluate needed modifications.

Gaining Insights Into the Estimation of the Circadian Rhythms of Social Activity in Older Adults From Their Telephone Call Activity With Statistical Learning: Observational Study.

BackgroundUnderstanding the social mechanisms of the circadian rhythms of activity represents a major issue in better managing the mechanisms of age-related diseases occurring over time in the elderly population. The automated analysis of call detail records (CDRs) provided by modern phone technologies can help meet such an objective. At this stage, however, whether and how the circadian rhythms of telephone call activity can be automatically and properly modeled in the elderly population remains to be established.ObjectiveOur goal for this study is to address whether and how the circadian rhythms of social activity observed through telephone calls could be automatically modeled in older adults.MethodsWe analyzed a 12-month data set of outgoing telephone CDRs of 26 adults older than 65 years of age. We designed a statistical learning modeling approach adapted for exploratory analysis. First, Gaussian mixture models (GMMs) were calculated to automatically model each participant’s circadian rhythm of telephone call activity. Second, k-means clustering was used for grouping participants into distinct groups depending on the characteristics of their personal GMMs.ResultsThe results showed the existence of specific structures of telephone call activity in the daily social activity of older adults. At the individual level, GMMs allowed the identification of personal habits, such as morningness-eveningness for making calls. At the population level, k-means clustering allowed the structuring of these individual habits into specific morningness or eveningness clusters.ConclusionsThese findings support the potential of phone technologies and statistical learning approaches to automatically provide personalized and precise information on the social rhythms of telephone call activity of older individuals. Futures studies could integrate such digital insights with other sources of data to complete assessments of the circadian rhythms of activity in elderly populations.

Rituals and rhythms at roadside memorials in Poland

ABSTRACT Roadside memorials are made up of objects, usually flowers, candles and crosses, placed at the roadside to mark the sites of fatal accidents. The paper introduces the potential of Lefebvre’s concept of rhythmanalysis and geography of rhythms in exploring roadside memorials. The aim of the paper is to investigate rituals and rhythms at roadside memorials in Poland. Data were collected during two-year field observations of 12 roadside memorials and from 10 semi-structured interviews. Polish roadside memorials are part of widespread rituals which either generate material changes to roadside memorials, like cleaning up works, leaving candles and flowers at memorials or which do not generate such changes, like saying prayers or reminiscing about the deceased. The specifics of roadside memorialisation in Poland are expressed in prayers being said and no personal belongings being left at the sites. We found that the coexistence of individual and social rhythms at roadside memorials was deeply rooted in Catholic liturgy and commonly accepted cemetery rituals in Poland.

Объективное время: в чем преимущества реалистического подхода к исследованию социальной темпоральности?

In the article, the author attempts to substantiate an object-oriented approach for the study of social temporality. To solve this problem, the author takes several steps. First, the author justifies the need for a realistic approach, since it allows us to substantiate the constitutive meaning of social temporality, as well as to show the possibility of understanding time beyond the functions of social practices and/or social processes. Second, the author shows the origins of realism in the classical philosophical tradition and analyzes the possibilities of neorealism and critical realism for understanding social time. Thanks to this, a way of thinking about the social was shown based on social actors (the study of their morphogenesis increases the validity of this category). At the final step, the author shows that objects can act as an ontological basis from which thinking about social time is possible. Using Graham Harman's interpretation of the object, the author considers time as an interobjective phenomenon, a function of objects, their relations, order and aspirations for interaction. Interobjectivity postulates the constitutive value of various objects for the construction of the social. The agency and self-reference of objects, justified by Graham Harman and Levi Bryant, make it possible to avoid the need for an observer figure, which is characteristic of the established social theory and corresponds to the principles of “flat ontology”. Thus, the proposed approach allows us to think about social time based on fundamental ontological grounds, which contributes to the leveling of the distortions of the observer's view. Unlike the models analyzed above, relying on objects allows us to think of time not only as linear and unidirectional (which is especially important for understanding social temporality): a realistic intention remains. Due to the interpretation of the object that opposes materialism and idealism, the field of research of social temporality is expanding, and time itself can be thought beyond the material/ideal dichotomy; also, social time does not oppose the physical one, since it is impossible to distinguish only “social” or “physical” objects (material and ideal, artificial and natural, and so on). The epistemological vector can thus shift from the study of social practices or rhythms of social life to the potential for changes contained in objects and object-oriented interpretations of causality.

Sleep Interventions in the Treatment of Schizophrenia and Bipolar Disorder.

Due to the effects of sleep on the central nervous system, it is thought that sleep disorders have a special importance in the onset, course and treatment of psychiatric diseases. Although the negative effects of sleep problems on the occurrence, recurrence and clinical course of psychiatric disorders are well known, it is reported that clinicians do not spend enough time for sleep problems in practice. This may be related to the fact that patients underreport their complaints for various reasons, insufficient examination time, and clinicians’ lack of knowledge about the importance of the subject. Pharmacotherapy, psychological and behavioral interventions are options among the therapeutic approaches to sleep problems. But, it seems that clinicians tend to prefer pharmacological approaches for the treatment of sleep problems. However, it is important to choose the appropriate treatment option with considering the method preferred by the patients, who already use many and high doses of pharmacological agents, the nature of the psychiatric disorder and the sleep problem. In this context, chronotherapeutic approaches such as bright light, sleep deprivation, interpersonal relations and social rhythm therapy, and cognitive behavioral therapy techniques adapted for patients with bipolar disorder can be used in the treatment of suitable patients. In this article, the current literature about sleep-related problems observed in patients with schizophrenia and bipolar disorder is reviewed comprehensively with presenting clinical phenotypes and treatment approaches.

Psychosocial Rehabilitation Interventions in the Treatment of Schizophrenia and Bipolar Disorder.

Schizophrenia and bipolar disorder are chronic conditions with the early onset, higher relapse rate, and functional impairment that often persist despite optimum pharmacotherapy, underscoring the need for adjunctive psychosocial treatments and rehabilitation interventions. Evidence-based psychosocial treatment and rehabilitation interventions for both illnesses are adherence therapy, psychoeducation, cognitive-behavioral therapy, interpersonal and social rhythm therapy, cognitive remediation, social skills training, family education, vocational rehabilitation, case management, assertive community treatment, occupational/art therapy, and peer support. The efficacy of these interventions has been shown in many studies. Trials generally reveal that symptom reductions, relapse preventions, reduced hospitalizations, increased social functioning, increased employment rate, and satisfactory quality of life for patients with schizophrenia and bipolar disorder are possible by using these interventions adding to optimal pharmacotherapy. This review describes the psychosocial rehabilitation interventions that have been used successfully and extensively in patients with schizophrenia and bipolar disorder.

The mental health and lifestyle impacts of COVID-19 on bipolar disorder

BackgroundIt is unclear how those with bipolar disorder (BD) have been affected by the coronavirus (COVID-19) pandemic. This study aimed to obtain a more detailed understanding of the current mental health needs of these individuals, which is important for both the development of intervention strategies to better manage patient distress and to better prepare for similar circumstances in future. MethodsThe sample comprised 43 individuals with a verified diagnosis of BD and 24 healthy controls. Data about pandemic-related mental health support use, socio-demographics, mood, lifestyle, social rhythm and subjective cognitive dysfunction data were collected and compared between groups. Inter-relationships between scores were also examined. ResultsNo between-group differences were found in terms of age, sex, living situation, job loss or reduced work hours due to COVID-19. Most patients with BD reported a history of ongoing formal psychological support (68.3%), with most continuing this support throughout the pandemic (82.1%). A large, statistically significant pandemic-related increase in subjective cognitive dysfunction was evident in the BD group. Subjective cognitive dysfunction was significantly associated with negative symptomology, suicidal thoughts, and quality of life ratings. LimitationsData was collected in self-report format in an online survey and objective symptom measures were not used at this time ConclusionThe absenceof substantial differences between patients and controls in terms of mood symptoms, COVID-19 fear or lifestyle factors and social rhythms suggests a degree of resilience in BD patients; despite large pandemic related increases in subjective cognitive dysfunction.

Impact of Social Jetlag and Circadian Patterns on Patients with Metabolic and Nocturnal Eating Syndromes

Objective Metabolic syndrome (MS) can result in many health hazards, including coronary heart disease, diabetes, fatty liver, and several types of cancer. Social jetlag is a discrepancy between biological and social timing. Circadian rhythm disruption is suggested to disturb the hypothalamus pituitary adrenal (HPA) axis. Disturbance of the HPA axis was reported to increase the risk of developing visceral obesity and MS. We hypothesized that social and circadian rhythm disruptions negatively impact patients with obesity and MS. This study aimed to detect the associations between obesity, MS, nocturnal eating syndrome, and social jetlag. Methods One hundred obese patients were recruited (61 had MS). The patient group was compared to a healthy nonobese control group (n=50). Each studied patient was subjected to three question-naires [Morningness Eveningness Questionnaire, Night Eating Questionnaire (NEQ), and Sleep Timing Questionnaire]; their anthropometric measures were taken, fasting lipid profile, liver, and kidney function tests, and fasting insulin were also assessed. Results Patients with evening chronotype were mainly from the obese with MS group. NEQ total score was higher in obese patients with MS, and it showed a significant positive correlation with BMI. Total cholesterol, NEQ score, age, sleep latency, and awakening after sleep onset had significant associations with MS. Conclusion Evening chronotype has a significant association with MS. Social jetlag negatively impacts obesity and MS, leading patients to have frequent nocturnal eating behaviors. Screening for sleep profile and social jetlag should be included in routine clinical practice of managing obesity. Key Words: Key WordsMetabolic syndrome; Obesity; Social jetlag; Chronotype, Night eating syndrome