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Psychiatrist, Dr. Mary Phillips, looks at links between circadian function, brain imaging and bipolar disorder in the first of two presentations on circadian function and bipolar disorder from UPMC. Then UPMC expert in mood disorders and their treatment, Dr. Ellen Frank, explores circadian sleep alignment in the patient with bipolar disorder.

Educational Objectives:

Upon completion of this activity, participants should be able to:

  • Analyze models suggesting a relationship between rhythm disruption and mood in individuals with bipolar disorder
  • Recognize the concept of the phase angle difference (PAD) between dim-light melatonin onset (DLMO) and habitual mid-point of sleep as a marker of integrity of the circadian system
  • Evaluate data suggesting that both the PAD and sleep timing may be abnormal in at least a subset of individuals with bipolar disorder even in the euthymic state
  • Identify abnormalities in reward circuitry in bipolar disorder
  • Describe impact of sleep deprivation on reward circuitry

Reading References:

  • Social rhythm disruption and stressful life events in the onset of bipolar and unipolar episodes. Malkoff-Schwartz S, Frank E, Anderson BP, Hlastala SA, Luther JF, Sherrill JT, Houck PR, Kupfer DJ. Psychol Med. 2000 Sep;30(5):1005-16.
  • Where's the fun in that? Broadening the focus on reward function in depression. Forbes EE. Biol Psychiatry. 2009 Aug 1;66(3):199-200. No abstract available.
  • Sleep and circadian rhythm disturbances in bipolar disorder: an urgent need for objective assessment and systematic follow-up. Kapczinski F, Frey BN, Vieta E. J Clin Psychiatry. 2011 May;72(5):724. No abstract available.


Dr. Phillips has no relevant relationships with any entities producing healthcare goods or services.
Dr. Frank is a consultant for Servier International and receives royalties from Guilford Press and the American Psychological Association.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditsTM. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1.0 contact hours.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 12/26/2012 | Last Modified On: 12/26/2012 | Expires: 12/26/2013

This course has been expired.