Chronotherapy shortens hospitalization for bipolar depression: a single-center replication across three decades (1994-2024)

Across three decades, the use of chronotherapy was consistently associated with shorter LOS in bipolar depression, despite major changes in clinical practice, organizational structure, and environmental circadian stressors. While causality cannot be inferred due to the observational design, these findings suggest that TSD-based chronotherapeutic interventions may represent a promising approach within acute inpatient care pathways, potentially contributing to improved hospitalization trajectories and discharge readiness in bipolar depression.