Influence of light exposure during early life on the age of onset of bipolar disorder

Michael Bauer; Tasha Glenn; Martin Alda; Ole A. Andreassen; Elias Angelopoulos; Raffaella Ardau; Christopher Baethge; Rita Bauer; Bernhard T. Baune; 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 Fagiolini; Mark A. Frye; Kostas N. Fountoulakis; Jade Garneau-Fournier; Ana Gonzalez-Pinto; John F. Gottlieb; 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 Miranda-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

doi:10.1016/j.jpsychires.2015.03.013

Influence of light exposure during early life on the age of onset of bipolar disorder

Michael Bauer, Tasha Glenn, Martin Alda, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Christopher Baethge, Rita Bauer, Bernhard T. Baune, 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 EtainAndrea Fagiolini, Mark A. Frye, Kostas N. Fountoulakis, Jade Garneau-Fournier, Ana Gonzalez-Pinto, John F. Gottlieb, 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 Miranda-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

Medicine

Producción científica: Contribución a una revista › Artículo de revisión › revisión exhaustiva

43 Citas (Scopus)

Resumen

Background: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. Methods: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4N and 70.7N, and 1.2S and 41.3S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. Results: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. Conclusions: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.

Idioma original	English
Páginas (desde-hasta)	1-8
Número de páginas	8
Publicación	Journal of Psychiatric Research
Volumen	64
DOI	https://doi.org/10.1016/j.jpsychires.2015.03.013
Estado	Published - may. 1 2015

Nota bibliográfica

Funding Information:
We thank the European College of Neuropsychopharmacology (ECNP) Network Initiative for supporting the European Network of Bipolar Research Expert Centres (ENBREC). This work was also funded in part by the following: Canadian Institutes of Health Research (MA, Grant number 64410 ); the Research Council of Norway (OAA Grant numbers 213837 ; 223273 ; 217776 ); South-East Norway Health Authority (OAA, Grant number 2013-123 ); a NHMRC Senior Principal Research Fellowship (M Berk, Grant number 1059660 ); INSERM (BE, Grant number C0829 ) and APHP (BE, Grant number AOR11096 ); the Spanish Government (AGP, Grant numbers PS09/02002 CIBER Network; EC10-333 , PI10/01430 , PI10/01746 , PI11/01977 , PI11/02708 , 2011/1064 , 11-BI-01 , 1677-DJ-030 , EC10-220 ); European Regional Development Funds (Grant numbers UE/2012/FI-STAR , UE/2013/TENDERMH , UE/2013/MASTERMIND ), grants from Spanish Government (Grant numbers PI10/01430 , PI10/01746 , EC10-220 , EC10-333 , PI11/01977 , 20111064 , PI11/02708 , PI12/02077 , PI13/02252 , PI13/00451 ), local grants from the Basque Government (Grant numbers 200911147 , 2010111170 , 2010112009 , 2011111110 , 2011111113 ); the Basque Foundation for Health Innovation and Research (Grant number BIO12/AL/002 ); the Spanish Clinical Research Network (Grant numbers CAIBER; 1392-D-079 ) and the University of the Basque Country (Grant number IT679-13 ); Stanley Research Foundation (Grant number 03-RC-003 ); the Research Council of Norway (IM, Grant numbers ES488722 , ES421716 ); the Regional Health Authority of South Eastern Norway (IM, Grants number 2011085 , 2013088 ); DFG (AR, Grant numbers SFB TRR 58 , B06 , Z02 ); the DFG and Länder funds (AR, Grant number RTG1252/2 ); Medical Research Council of South Africa (DJS); Spanish Ministry of Economy and Competitiveness (EV, Grants number PI12/00912 , PN 2008-2011 ); the Instituto de Salud Carlos III- Subdirección General de Evaluación y Fomento de la Investigación (EV); Fondo Europeo de Desarrollo Regional Unión Europea. Una manera de hacer Europa (EV); CIBERSAM (EV); the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya to the Bipolar Disorders Group (EV, Grant number 2009 SGR 1022 ), and the Department of Science and Technology INSPIRE scheme , Government of India (BV).

Publisher Copyright:
© 2015 Elsevier Ltd.

ASJC Scopus Subject Areas

Psychiatry and Mental health
Biological Psychiatry

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Bauer, M., Glenn, T., Alda, M., Andreassen, O. A., Angelopoulos, E., Ardau, R., Baethge, C., Bauer, R., Baune, B. T., Bellivier, F., Belmaker, R. H., Berk, M., Bjella, T. D., Bossini, L., Bersudsky, Y., Wo Cheung, E. Y., Conell, J., Del Zompo, M., Dodd, S., ... Whybrow, P. C. (2015). Influence of light exposure during early life on the age of onset of bipolar disorder. Journal of Psychiatric Research, 64, 1-8. https://doi.org/10.1016/j.jpsychires.2015.03.013

Bauer, M, Glenn, T, Alda, M, Andreassen, OA, Angelopoulos, E, Ardau, R, Baethge, C, Bauer, R, Baune, BT, Bellivier, F, Belmaker, RH, Berk, M, Bjella, TD, Bossini, L, Bersudsky, Y, Wo Cheung, EY, Conell, J, Del Zompo, M, Dodd, S, Etain, B, Fagiolini, A, Frye, MA, Fountoulakis, KN, Garneau-Fournier, J, Gonzalez-Pinto, A, Gottlieb, JF, Harima, H, Hassel, S, Henry, C, Iacovides, A, Isometsä, ET, Kapczinski, F, Kliwicki, S, König, B, Krogh, R, Kunz, M, Lafer, B, Larsen, ER, Lewitzka, U, Lopez-Jaramillo, C, MacQueen, G, Manchia, M, Marsh, W, Martinez-Cengotitabengoa, M, Melle, I, Monteith, S, Morken, G, Munoz, R, Nery, FG, O'Donovan, C, Osher, Y, Pfennig, A, Quiroz, D, Ramesar, R, Rasgon, N, Reif, A, Ritter, P, Rybakowski, JK, Sagduyu, K, Miranda-Scippa, Â, Severus, E, Simhandl, C, Stein, DJ, Strejilevich, S, Sulaiman, AH, Suominen, K, Tagata, H, Tatebayashi, Y, Torrent, C, Vieta, E, Viswanath, B, Wanchoo, MJ, Zetin, M & Whybrow, PC 2015, 'Influence of light exposure during early life on the age of onset of bipolar disorder', Journal of Psychiatric Research, vol. 64, pp. 1-8. https://doi.org/10.1016/j.jpsychires.2015.03.013

@article{a48dd905d37c4e08acb405fd560e25a5,

title = "Influence of light exposure during early life on the age of onset of bipolar disorder",

abstract = "Background: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. Methods: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4N and 70.7N, and 1.2S and 41.3S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. Results: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. Conclusions: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.",

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

note = "Funding Information: We thank the European College of Neuropsychopharmacology (ECNP) Network Initiative for supporting the European Network of Bipolar Research Expert Centres (ENBREC). This work was also funded in part by the following: Canadian Institutes of Health Research (MA, Grant number 64410 ); the Research Council of Norway (OAA Grant numbers 213837 ; 223273 ; 217776 ); South-East Norway Health Authority (OAA, Grant number 2013-123 ); a NHMRC Senior Principal Research Fellowship (M Berk, Grant number 1059660 ); INSERM (BE, Grant number C0829 ) and APHP (BE, Grant number AOR11096 ); the Spanish Government (AGP, Grant numbers PS09/02002 CIBER Network; EC10-333 , PI10/01430 , PI10/01746 , PI11/01977 , PI11/02708 , 2011/1064 , 11-BI-01 , 1677-DJ-030 , EC10-220 ); European Regional Development Funds (Grant numbers UE/2012/FI-STAR , UE/2013/TENDERMH , UE/2013/MASTERMIND ), grants from Spanish Government (Grant numbers PI10/01430 , PI10/01746 , EC10-220 , EC10-333 , PI11/01977 , 20111064 , PI11/02708 , PI12/02077 , PI13/02252 , PI13/00451 ), local grants from the Basque Government (Grant numbers 200911147 , 2010111170 , 2010112009 , 2011111110 , 2011111113 ); the Basque Foundation for Health Innovation and Research (Grant number BIO12/AL/002 ); the Spanish Clinical Research Network (Grant numbers CAIBER; 1392-D-079 ) and the University of the Basque Country (Grant number IT679-13 ); Stanley Research Foundation (Grant number 03-RC-003 ); the Research Council of Norway (IM, Grant numbers ES488722 , ES421716 ); the Regional Health Authority of South Eastern Norway (IM, Grants number 2011085 , 2013088 ); DFG (AR, Grant numbers SFB TRR 58 , B06 , Z02 ); the DFG and L{\"a}nder funds (AR, Grant number RTG1252/2 ); Medical Research Council of South Africa (DJS); Spanish Ministry of Economy and Competitiveness (EV, Grants number PI12/00912 , PN 2008-2011 ); the Instituto de Salud Carlos III- Subdirecci{\'o}n General de Evaluaci{\'o}n y Fomento de la Investigaci{\'o}n (EV); Fondo Europeo de Desarrollo Regional Uni{\'o}n Europea. Una manera de hacer Europa (EV); CIBERSAM (EV); the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya to the Bipolar Disorders Group (EV, Grant number 2009 SGR 1022 ), and the Department of Science and Technology INSPIRE scheme , Government of India (BV). Publisher Copyright: {\textcopyright} 2015 Elsevier Ltd.",

year = "2015",

month = may,

day = "1",

doi = "10.1016/j.jpsychires.2015.03.013",

language = "English",

volume = "64",

pages = "1--8",

journal = "Journal of Psychiatric Research",

issn = "0022-3956",

publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Influence of light exposure during early life on the age of onset of bipolar disorder

AU - Bauer, Michael

AU - Glenn, Tasha

AU - Alda, Martin

AU - Andreassen, Ole A.

AU - Angelopoulos, Elias

AU - Ardau, Raffaella

AU - Baethge, Christopher

AU - Bauer, Rita

AU - Baune, Bernhard T.

AU - Bellivier, Frank

AU - Belmaker, Robert H.

AU - Berk, Michael

AU - Bjella, Thomas D.

AU - Bossini, Letizia

AU - Bersudsky, Yuly

AU - Wo Cheung, Eric Yat

AU - Conell, Jörn

AU - Del Zompo, Maria

AU - Dodd, Seetal

AU - Etain, Bruno

AU - Fagiolini, Andrea

AU - Frye, Mark A.

AU - Fountoulakis, Kostas N.

AU - Garneau-Fournier, Jade

AU - Gonzalez-Pinto, Ana

AU - Gottlieb, John F.

AU - Harima, Hirohiko

AU - Hassel, Stefanie

AU - Henry, Chantal

AU - Iacovides, Apostolos

AU - Isometsä, Erkki T.

AU - Kapczinski, Flávio

AU - Kliwicki, Sebastian

AU - König, Barbara

AU - Krogh, Rikke

AU - Kunz, Mauricio

AU - Lafer, Beny

AU - Larsen, Erik R.

AU - Lewitzka, Ute

AU - Lopez-Jaramillo, Carlos

AU - MacQueen, Glenda

AU - Manchia, Mirko

AU - Marsh, Wendy

AU - Martinez-Cengotitabengoa, Mónica

AU - Melle, Ingrid

AU - Monteith, Scott

AU - Morken, Gunnar

AU - Munoz, Rodrigo

AU - Nery, Fabiano G.

AU - O'Donovan, Claire

AU - Osher, Yamima

AU - Pfennig, Andrea

AU - Quiroz, Danilo

AU - Ramesar, Raj

AU - Rasgon, Natalie

AU - Reif, Andreas

AU - Ritter, Philipp

AU - Rybakowski, Janusz K.

AU - Sagduyu, Kemal

AU - Miranda-Scippa, Ângela

AU - Severus, Emanuel

AU - Simhandl, Christian

AU - Stein, Dan J.

AU - Strejilevich, Sergio

AU - Sulaiman, Ahmad Hatim

AU - Suominen, Kirsi

AU - Tagata, Hiromi

AU - Tatebayashi, Yoshitaka

AU - Torrent, Carla

AU - Vieta, Eduard

AU - Viswanath, Biju

AU - Wanchoo, Mihir J.

AU - Zetin, Mark

AU - Whybrow, Peter C.

N1 - Funding Information: We thank the European College of Neuropsychopharmacology (ECNP) Network Initiative for supporting the European Network of Bipolar Research Expert Centres (ENBREC). This work was also funded in part by the following: Canadian Institutes of Health Research (MA, Grant number 64410 ); the Research Council of Norway (OAA Grant numbers 213837 ; 223273 ; 217776 ); South-East Norway Health Authority (OAA, Grant number 2013-123 ); a NHMRC Senior Principal Research Fellowship (M Berk, Grant number 1059660 ); INSERM (BE, Grant number C0829 ) and APHP (BE, Grant number AOR11096 ); the Spanish Government (AGP, Grant numbers PS09/02002 CIBER Network; EC10-333 , PI10/01430 , PI10/01746 , PI11/01977 , PI11/02708 , 2011/1064 , 11-BI-01 , 1677-DJ-030 , EC10-220 ); European Regional Development Funds (Grant numbers UE/2012/FI-STAR , UE/2013/TENDERMH , UE/2013/MASTERMIND ), grants from Spanish Government (Grant numbers PI10/01430 , PI10/01746 , EC10-220 , EC10-333 , PI11/01977 , 20111064 , PI11/02708 , PI12/02077 , PI13/02252 , PI13/00451 ), local grants from the Basque Government (Grant numbers 200911147 , 2010111170 , 2010112009 , 2011111110 , 2011111113 ); the Basque Foundation for Health Innovation and Research (Grant number BIO12/AL/002 ); the Spanish Clinical Research Network (Grant numbers CAIBER; 1392-D-079 ) and the University of the Basque Country (Grant number IT679-13 ); Stanley Research Foundation (Grant number 03-RC-003 ); the Research Council of Norway (IM, Grant numbers ES488722 , ES421716 ); the Regional Health Authority of South Eastern Norway (IM, Grants number 2011085 , 2013088 ); DFG (AR, Grant numbers SFB TRR 58 , B06 , Z02 ); the DFG and Länder funds (AR, Grant number RTG1252/2 ); Medical Research Council of South Africa (DJS); Spanish Ministry of Economy and Competitiveness (EV, Grants number PI12/00912 , PN 2008-2011 ); the Instituto de Salud Carlos III- Subdirección General de Evaluación y Fomento de la Investigación (EV); Fondo Europeo de Desarrollo Regional Unión Europea. Una manera de hacer Europa (EV); CIBERSAM (EV); the Comissionat per a Universitats i Recerca del DIUE de la Generalitat de Catalunya to the Bipolar Disorders Group (EV, Grant number 2009 SGR 1022 ), and the Department of Science and Technology INSPIRE scheme , Government of India (BV). Publisher Copyright: © 2015 Elsevier Ltd.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. Methods: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4N and 70.7N, and 1.2S and 41.3S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. Results: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. Conclusions: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.

AB - Background: Environmental conditions early in life may imprint the circadian system and influence response to environmental signals later in life. We previously determined that a large springtime increase in solar insolation at the onset location was associated with a younger age of onset of bipolar disorder, especially with a family history of mood disorders. This study investigated whether the hours of daylight at the birth location affected this association. Methods: Data collected previously at 36 collection sites from 23 countries were available for 3896 patients with bipolar I disorder, born between latitudes of 1.4N and 70.7N, and 1.2S and 41.3S. Hours of daylight variables for the birth location were added to a base model to assess the relation between the age of onset and solar insolation. Results: More hours of daylight at the birth location during early life was associated with an older age of onset, suggesting reduced vulnerability to the future circadian challenge of the springtime increase in solar insolation at the onset location. Addition of the minimum of the average monthly hours of daylight during the first 3 months of life improved the base model, with a significant positive relationship to age of onset. Coefficients for all other variables remained stable, significant and consistent with the base model. Conclusions: Light exposure during early life may have important consequences for those who are susceptible to bipolar disorder, especially at latitudes with little natural light in winter. This study indirectly supports the concept that early life exposure to light may affect the long term adaptability to respond to a circadian challenge later in life.

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U2 - 10.1016/j.jpsychires.2015.03.013

DO - 10.1016/j.jpsychires.2015.03.013

M3 - Review article

C2 - 25862378

AN - SCOPUS:84928209426

SN - 0022-3956

VL - 64

SP - 1

EP - 8

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

ER -

Influence of light exposure during early life on the age of onset of bipolar disorder

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ASJC Scopus Subject Areas

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