{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:23:15Z","timestamp":1788315795380,"version":"build-2803163510"},"reference-count":44,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Public Health Research"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating habits, and social interactions, before the lockdown period, was a determinant for depressive episodes during the lockdown; (2) In tighter lockdowns, DBR triggered depressive episodes in bipolar patients; (3) DBR in healthcare workers under pressure was a determinant of burnout; (4) DBR influenced the course of chronic diseases by altering immune responses. In addition, it was found that scoring positive on the Mood Disorder Questionnaire (MDQ) was closely associated with the dysregulation of sleep rhythms. MDQ is a screening tool for bipolar disorder (BD), criticized for detecting too many false positives. Studies showed that positivity to the MDQ implied a severe impairment of quality of life even in people without psychiatric diagnoses. According to this evidence, three different hyperactivation levels could be proposed (from normality to pathology): firstly, an adaptive increase in energy (e.g. athletes performing well); secondly, a DBR determined from the continuous stimulation of stress hormones, with possible positive scores on the MDQ without a diagnosis of bipolar disorder, like in burnout syndromes and, thirdly, hyperactivity during manic episodes. The Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS), the second level of the scale, is proposed as a working hypothesis. DYMERS is also seen as a vulnerable condition that may evolve in other disorders (including BD) according to the individual susceptibility (including genetic predisposition) and the specific nature\/level of the stressor.<\/jats:p>","DOI":"10.1177\/22799036241248022","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T05:30:15Z","timestamp":1714023015000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Dysregulation of mood, energy, and social rhythms syndrome (DYMERS): A working hypothesis"],"prefix":"10.1177","volume":"13","author":[{"given":"Mauro Giovanni","family":"Carta","sequence":"first","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Fornaro","sequence":"additional","affiliation":[{"name":"Section of Psychiatry - Department of Neuroscience, Reproductive Sciences, and Dentistry, University School of Medicine Federico II, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Primavera","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio Egidio","family":"Nardi","sequence":"additional","affiliation":[{"name":"Laboratory Panic and Respiration, Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie","family":"Karam","sequence":"additional","affiliation":[{"name":"Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon and Department of Psychiatry and Clinical Psychology, St Georges University of Beirut, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"bibr1-22799036241248022","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2014.913422"},{"key":"bibr2-22799036241248022","doi-asserted-by":"publisher","DOI":"10.2174\/1745017901814010033"},{"key":"bibr3-22799036241248022","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2016.262"},{"key":"bibr4-22799036241248022","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12010087"},{"key":"bibr5-22799036241248022","doi-asserted-by":"publisher","DOI":"10.4081\/jphr.2022.2768"},{"key":"bibr6-22799036241248022","doi-asserted-by":"crossref","unstructured":"Carta MG, Ouali U, Perra A, et al. 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