Irregular eating patterns associate with hypomanic symptoms in bipolar disorders

ABSTRACT

Objective: We present novel dimensional methods to describe the timing of eating in psychopathology. We focused on the relationship between current mood in bipolar disorder (BD) and the stability of the temporal pattern of daily eating events.

Methods: Consenting BD patients (n = 69) from an outpatient, tertiary care clinic completed hourly charts of mood and eating for two weeks. Mood was also evaluated with Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS).

Results: Illustrative displays, or eatograms, enabling visualization of all recorded eating events were used to guide assessment of the temporal structure of eating across the two week assessment period. We computed indices to quantify irregularities in timing of eating, namely I^FRQ, I^TIM and I^INT for the variability of frequency, timing, and interval of eating events, respectively. In this cohort, irregular temporal pattern of eating correlated with hypomanic symptoms (YMRS with I^FRQ, Spearman rank order rh = 0.28, p = .019, with I^TIM, rh = 0.44, p < .001, and with I^INT rh = 0.38, p = .001), but not depressive symptoms or anthropometric measures.

Conclusions: Our data suggest a link between the instability of the temporal order of daily eating and mood. The dimensional measures for eating pattern introduced here enable future investigations of correlations with psychopathology.

GRAPHICAL ABSTRACT

KEYWORDS:

• Bipolar disorder
• eating frequency
• eating pattern
• irregular eating
• disordered eating
• depressive
• manic
• hypomanic

Acknowledgements

We thank the personnel of the Bipolar Disorders Clinic at the Douglas Mental Health University Institute for help in data collection, and Josée Martin and Vasile Catana for data management. We thank all study participants and employees at the clinic.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Asli Buyukkurt has an undergraduate degree in neuroscience and is currently pursuing Doctor of Medicine and Master of Surgery degree at McGill University. Her current research interests include qualitative assessment of patient experiences and perceptions of medical care.

Clément Bourguignon is a PhD candidate in the Integrated Program in Neuroscience at McGill University, Montréal, Canada with a research focus on behavioral rhythms in rodent models and humans. He obtained a Master of Science in neuroscience from Université de Bordeaux, France, and a Bachelor of Science in biology from Université de Tours, France.

Christina Antinora obtained B.Sc. in Pharmacology and Therapeutics and is currently pursuing a Doctor of Medicine and Master of Surgery degree at McGill University.

Elisabeth Farquhar is a Master of Psychology candidate at McGill University.

Xiaoya Gao is a Doctor of Medicine and Master of Surgery candidate at McGill University. Her main research interests are clinical psychiatry, neuroscience, and malignancy.

Eloise Passarella is a Doctor of Medicine and Master of Surgery candidate at McGill University.

Duncan Sibthorpe is a Doctor of Medicine and Master of Surgery candidate at McGill University. His research focus is the relationship between circadian rhythm disruptions and eating disorders.

Karine Gou is a Doctor of Medicine and Master of Surgery candidate at McGill University and has an interest in chronobiological and mood disorder studies.

Sybille Saury has obtained a Master in Psychology and is a research coordinator at the Douglas Mental Health University Institute.

Serge Beaulieu obtained B.Sc. in Biochemistry, M.Sc. in Neurobiology, and Ph.D in Physiology, as well as an MD and a training as a clinical psychiatrist. He is an Associate Professor at McGill University in the Department of Psychiatry and holds associate membership in the Department of Neurology and Neurosurgery. He has been the Medical Chief of the Bipolar Disorders Clinic at the Douglas Mental Health University Clinic since 2001 and the Executive Chair of the Canadian Network for Mood and Anxiety Treatments workgroup.

Kai-Florian Storch is an Associate Professor in the Department of Psychiatry at McGill University, Canada. He is a circadian biologist at the Douglas Mental Health University Institute with a specific interest in ultradian rhythms and sleep:wake cycle regulation in the context of psychopathology. He combines mouse model work with human studies with the aim to elucidate the biological underpinnings of rhythmic behaviors in health and disease.

Outi Linnaranta (previously, Mantere) is an Associate Professor in the Department of Psychiatry at McGill University and at the Douglas Mental Health University Institute, Canada. She has an MD, PhD training as a clinical psychiatrist, and an epidemiologist at University of Helsinki in Finland and works in translational research to describe inflammatory, metabolic, and rhythmic dysregulation in severe mental illness.

Additional information

Funding

This work was supported by Canadian institutes of Health Research, The Fonds de recherche du Québec – Santé (FRQS); Mach-Gaensslen Foundation Bursary; Dr. Clarke K. McLeod Memorial Scholarship; Edward Beatty Research Award; Harold and Rhea Pugash Research Bursary; and Bristol-Myers-Squibb.