Relationship between sunlight and the age of onset of bipolar disorder: an international multisite study

Michael Bauer, Tasha Glenn, Martin Alda, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Christopher Baethge, Rita Bauer, Frank Bellivier, Robert H. Belmaker, Michael Berk, Thomas D. Bjella, Letizia Bossini, Yuly Bersudsky, Eric Yat Wo Cheung, Jörn Conell, Maria del Zompo, Seetal Dodd, Bruno Etain, Andrea FagioliniMark A. Frye, Kostas N. Fountoulakis, Jade Garneau-Fournier, Ana González-Pinto, Hirohiko Harima, Stefanie Hassel, Chantal Henry, Apostolos Iacovides, Erkki T. Isometsä, Flávio Kapczinski, Sebastian Kliwicki, Barbara König, Rikke Krogh, Mauricio Kunz, Beny Lafer, Erik R. Larsen, Ute Lewitzka, Carlos Lopez-Jaramillo, Glenda MacQueen, Mirko Manchia, Wendy Marsh, Mónica Martinez-Cengotitabengoa, Ingrid Melle, Scott Monteith, Gunnar Morken, Rodrigo Munoz, Fabiano G. Nery, Claire O'Donovan, Yamima Osher, Andrea Pfennig, Danilo Quiroz, Raj Ramesar, Natalie Rasgon, Andreas Reif, Philipp Ritter, Janusz K. Rybakowski, Kemal Sagduyu, Ângela M. Scippa, Emanuel Severus, Christian Simhandl, Dan J. Stein, Sergio Strejilevich, Ahmad Hatim Sulaiman, Kirsi Suominen, Hiromi Tagata, Yoshitaka Tatebayashi, Carla Torrent, Eduard Vieta, Biju Viswanath, Mihir J. Wanchoo, Mark Zetin, Peter C. Whybrow

Research output: Contribution to journalArticlepeer-review


Background - The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode.
Methods - Data from 4037 patients with bipolar I disorder were collected at 36 collection sites in 23 countries at latitudes spanning 3.2 north (N) to 63.4 N and 38.2 south (S) of the equator. The age of onset of the first episode, onset location, family history of mood disorders, and polarity of first episode were obtained retrospectively, from patient records and/or direct interview. Solar insolation data were obtained for the onset locations.
Results - There was a large, significant inverse relationship between maximum monthly increase in solar insolation and age of onset, controlling for the country median age and the birth cohort. The effect was reduced by half if there was no family history. The maximum monthly increase in solar insolation occurred in springtime. The effect was one-third smaller for initial episodes of mania than depression. The largest maximum monthly increase in solar insolation occurred in northern latitudes such as Oslo, Norway, and warm and dry areas such as Los Angeles, California.
Limitations - Recall bias for onset and family history data.
Conclusions - A large springtime increase in sunlight may have an important influence on the onset of bipolar disorder, especially in those with a family history of mood disorders.
Original languageEnglish
Pages (from-to)104-111
Number of pages8
JournalJournal of Affective Disorders
Early online date29 May 2014
Publication statusPublished - 1 Oct 2014


  • bipolar disorder
  • sunlight
  • insolation
  • age of onset


Dive into the research topics of 'Relationship between sunlight and the age of onset of bipolar disorder: an international multisite study'. Together they form a unique fingerprint.

Cite this