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Social jetlag and risk of depression: Results from the Korea National Health and Nutrition Examination Survey. J Affect Disord 2023; 323:562-569. [PMID: 36496100 DOI: 10.1016/j.jad.2022.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Social jetlag, which is the mismatch between endogenous rhythm and social timing, is prevalent among the working population. Social jetlag may result in mood changes; however, evidence of relationship between social jetlag and depressive disorders has not been fully verified. Hence, this study aimed to investigate the association between social jetlag and depressive symptoms in a representative working population of South Korea. METHODS This study included 5447 Korean employees in the Korea National Health and Nutrition Examination Survey. Social jetlag was calculated as the difference between the midpoint of sleep time on weekdays and free days. Depressive symptoms were assessed using Patient Health Questionnaire-9. Multiple logistic regression was used to estimate the odds ratio after adjusting for confounding factors. Moreover, social jetlag and continuous depression scores were evaluated using linear regression and generalized additive models. RESULTS The proportion of the participants who had >2 h of social jetlag was 10.26 %. Depressive symptoms increased as social jetlag increased. Multiple logistic regression analysis showed that the adjusted OR (95 % confidence interval) for 1 to 2 h of social jetlag was 1.355 (0.891-2.059) and for >2 h was 1.859 (1.084-3.187), which <1 h was reference. LIMITATIONS This study used a cross-sectional design and measurements were based on self-reported scales. CONCLUSION This study found that social jetlag and depressive symptoms were significantly related in the Korean working population.
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Al-Rfooh OF, Khater W. The impact of chronotype on physical health, psychological health, and job performance among health care providers in acute care settings. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2023. [DOI: 10.1080/20479700.2023.2177665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- Omar Faisal Al-Rfooh
- Faculty of Nursing/Jordan University of Science and Technology, School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Wejdan Khater
- Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Amman, Jordan
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Quasi-causal associations between chronotype and post-traumatic stress disorder symptoms: A twin study. Sleep Health 2023; 9:218-227. [PMID: 36775751 DOI: 10.1016/j.sleh.2023.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE The evening ("night owl") chronotype is associated with greater severity and lifetime prevalence of post-traumatic stress disorder (PTSD) symptoms compared to morning or intermediate chronotypes. This twin study investigated the gene-environment relationships between chronotype, recent PTSD symptoms, and lifetime intrusive symptoms. METHODS We used the reduced Horne-Östberg Morningness-Eveningness Questionnaire (rMEQ) to assess chronotype in a sample of 3777 same-sex adult twin pairs raised together (70.4% monozygotic, 29.6% dizygotic) in the community-based Washington State Twin Registry. PTSD symptoms were reported on the Impact of Events Scale (IES) and a single item for lifetime experience of intrusive symptoms after a stressful or traumatic event. RESULTS Genetic influences accounted for 50% of chronotype variance, 30% of IES score variance, and 14% of lifetime intrusive symptom variance. Bivariate twin models showed a phenotypic association (bp) between evening chronotype and more severe PTSD symptoms (bp = -0.16, SE = 0.02, p < .001) that remained significant even after adjusting for shared genetic and environmental influences (bp = -0.10, SE = 0.04, p = .009), as well as age, sex, and self-reported sleep duration (bp = -0.11, SE = 0.04, p = .004). An association was found between evening chronotype and lifetime intrusive symptoms (bp = -0.11, SE = 0.03, p < .001) that was no longer significant after adjusting for shared genetic and environmental influences (bp = 0.04, SE = 0.06, p = .558). CONCLUSIONS Our results suggest a "quasi-causal" relationship between evening chronotype and PTSD symptoms that is not purely attributable to genetic or shared environmental factors. Evening chronotype may increase vulnerability to pathologic stress responses in the setting of circadian misalignment, providing potential avenues of prevention and treatment using chronobiological strategies.
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54
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Gomes SRBS, von Schantz M, Leocadio-Miguel M. Predicting depressive symptoms in middle-aged and elderly adults using sleep data and clinical health markers: A machine learning approach. Sleep Med 2023; 102:123-131. [PMID: 36641929 DOI: 10.1016/j.sleep.2023.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/13/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Comorbid depression is a highly prevalent and debilitating condition in middle-aged and elderly adults, particularly when associated with obesity, diabetes, and sleep disturbances. In this context, there is a growing need to develop efficient screening methods for cases based on clinical health markers for these comorbidities and sleep data. Thus, our objective was to detect depressive symptoms in these subjects, considering general biomarkers of obesity and diabetes and variables related to sleep and physical exercise through a machine learning approach. METHODS We used the National Health and Nutrition Examination Survey (NHANES) 2015-2016 data. Eighteen variables on self-reported physical activity, self-reported sleep habits, sleep disturbance indicative, anthropometric measurements, sociodemographic characteristics and plasma biomarkers of obesity and diabetes were selected as predictors. A total of 2907 middle-aged and elderly subjects were eligible for the study. Supervised learning algorithms such as Lasso penalized Logistic Regression (LR), Random Forest (RF) and Extreme Gradient Boosting (XGBoost) were implemented. RESULTS XGBoost provided greater accuracy and precision (87%), with a proportion of hits in cases with depressive symptoms above 80%. In addition, daytime sleepiness was the most significant predictor variable for predicting depressive symptoms. CONCLUSIONS Sleep and physical activity variables, in addition to obesity and diabetes biomarkers, together assume significant importance to predict, with accuracy and precision of 87%, the occurrence of depressive symptoms in middle-aged and elderly individuals.
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Affiliation(s)
| | | | - Mario Leocadio-Miguel
- Department of Physiology and Behavior, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil.
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55
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Facanha CFS, Alencar VS, Machado PS, Macêdo RBL, de Bruin PFC, Costa E Forti A, Rocha TM, de Bruin VMS. Morningness/eveningness in gestational diabetes mellitus: clinical characteristics and maternal-neonatal outcomes. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:92-100. [PMID: 36155121 PMCID: PMC9983797 DOI: 10.20945/2359-3997000000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Objective This study aims to evaluate the impact of morning-evening preference in pregnancy outcomes in gestational diabetes mellitus (GDM). Methods This is a prospective cohort study of 2nd-3rd trimester GDM outpatient care in Fortaleza, Brazil (2018-2020). Eveningness was defined by the Horne-Östberg Morningness-Eveningness-Questionnaire (MEQ ≤ 41). Furthermore, we obtained a 7-day actigraphic register. Subjective sleep quality, daytime somnolence, insomnia, fatigue and depressive symptoms were also evaluated. Associations with pregnancy outcomes were investigated. Results Among 305 patients with GDM, evening preference was found in 21 (6.9%). Patients with evening preference had worse sleep quality (p < 0.01), greater severity of insomnia (p < 0.005), fatigue (p < 0.005) and depressive symptoms (<0.009). Evening chronotype was associated with preeclampsia [p = 0.01; OR = 0.27; CI 0.09-0.79] and a greater need for admission to a neonatal intensive care unit (NICU) [p = 0.02; OR = 0.23; CI .0.06-0.80]. A lower MEQ score confirmed an association with preeclampsia [p = 0.002; OR = 0.94; CI 0.90-0.97] and this was maintained after controlling for age, arterial hypertension, sleep quality, fatigue and depressive symptoms [p < 005; OR = 0.91; CI 0.87-0.95]. Conclusion In GDM, patients with evening preference had worse sleep quality, more insomnia, fatigue, and depressive symptoms. Furthermore, eveningness was independently associated with preeclampsia. These results indicate the important role of eveningness in adverse pregnancy outcomes.
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Affiliation(s)
- Cristina Figueiredo Sampaio Facanha
- Departamento de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil, ; .,Departamento de Medicina, Centro Universitário Christus, Fortaleza, CE, Brasil.,Centro Integrado de Diabetes e Hipertensão do Ceará (CIDH), Secretaria Estadual de Saúde do Ceará, Fortaleza, CE, Brasil
| | | | | | - Rejane Belchior Lima Macêdo
- Departamento de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.,Centro Integrado de Diabetes e Hipertensão do Ceará (CIDH), Secretaria Estadual de Saúde do Ceará, Fortaleza, CE, Brasil
| | | | - Adriana Costa E Forti
- Departamento de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.,Centro Integrado de Diabetes e Hipertensão do Ceará (CIDH), Secretaria Estadual de Saúde do Ceará, Fortaleza, CE, Brasil
| | - Thaine Mirla Rocha
- Departamento de Medicina, Centro Universitário Christus, Fortaleza, CE, Brasil
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Tubbs AS, Taneja K, Ghani SB, Nadorff MR, Drapeau CW, Karp JF, Fernandez FX, Perlis ML, Grandner MA. Sleep continuity, timing, quality, and disorder are associated with suicidal ideation and suicide attempts among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 36596225 DOI: 10.1080/07448481.2022.2155828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/12/2022] [Accepted: 10/23/2022] [Indexed: 06/17/2023]
Abstract
Objective: To evaluate sleep continuity, timing, quality, and disorder in relation to suicidal ideation and attempts among college students. Participants: Eight hundred eighty-five undergraduates aged 18-25 in the southwestern United States. Methods: Participants completed questionnaires on sleep, suicide risk, mental health, and substance use. Differences in sleep variables were compared by lifetime and recent suicidal ideation and suicide attempts using covariate-adjusted and stepwise regression models. Results: A total of 363 (41.0%) individuals reported lifetime suicidal ideation, of whom 172 (47.4%) reported suicidal ideation in the last 3 months and 97 (26.7%) had attempted suicide in their lifetime. Sleep disturbances were prevalent among those with lifetime suicidal ideation or a lifetime suicide attempt. Insomnia was identified as the best predictor of recent suicidal ideation, but this relationship did not survive adjustment for covariates. Conclusions: Sleep continuity, quality, and sleep disorders are broadly associated with suicidal thoughts and behaviors among college students.
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Affiliation(s)
- Andrew S Tubbs
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Krishna Taneja
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Sadia B Ghani
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Christopher W Drapeau
- Department of Health Policy and Management, School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, Indiana, USA
| | - Jordan F Karp
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
| | | | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona College of Medicine - Tucson, Tucson, Arizona, USA
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Xu C, Xu H, Yang Z, Guo C. Regional shape alteration of left thalamus associated with late chronotype in young adults. Chronobiol Int 2023; 40:234-245. [PMID: 36597182 DOI: 10.1080/07420528.2022.2162916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Chronotype reflects individual differences in circadian rhythms and influences individual psychology and behavior. Previous studies found altered subcortical structures are closely related to individual chronotypes. However, these studies have been conducted mainly using voxel-based morphometry and traditional volume measurement methods with certain limitations. This study aimed to investigate subcortical aberrant volume and shape patterns in late chronotypes (LC) young adults compared to early chronotypes (EC) young adults. Magnetic resonance imaging (MRI) scanning and chronotype assessment were performed once for all participants, including 49 LC young adults and 49 matched EC young adults. The morningness and eveningness preferences were assessed using the Chronotype Questionnaire. A vertex-wise shape analysis was conducted to analyze structural MRI data. There were no significant differences in brain tissue volume and subcortical structural volume between groups. LC young adults showed significant regional shape atrophy in the left ventral posterior thalamus compared to EC individuals. A significant correlation was found between the regional shape atrophy of left ventral posterior thalamus and the score of Chronotype Questionnaire in LC young adults. Regional shape alteration of left thalamus was closely related to the chronotype, and LC may be a potential risk factor for sleep-related behavioral and mental problems in young adults. However, the predominantly female sample and the failure to investigate the effect of chronotype on the subcortical structure-function network are limitations of this study. Further prospective studies are needed to investigate the temporal characteristics of thalamic shape changes and consequent behavioral and psychiatric problems in adults with LC.
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Affiliation(s)
- Cheng Xu
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Hui Xu
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Zhenliang Yang
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Chenguang Guo
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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The Interplay between Chronotype and Emotion Regulation in the Recognition of Facial Expressions of Emotion. Behav Sci (Basel) 2022; 13:bs13010038. [PMID: 36661610 PMCID: PMC9855169 DOI: 10.3390/bs13010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/12/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
Emotion regulation strategies affect the experience and processing of emotions and emotional stimuli. Chronotype has also been shown to influence the processing of emotional stimuli, with late chronotypes showing a bias towards better processing of negative stimuli. Additionally, greater eveningness has been associated with increased difficulties in emotion regulation and preferential use of expressive suppression strategies. Therefore, the present study aimed to understand the interplay between chronotype and emotion regulation on the recognition of dynamic facial expressions of emotion. To that end, 287 participants answered self-report measures and performed an online facial emotion recognition task from short video clips where a neutral face gradually morphed into a full-emotion expression (one of the six basic emotions). Participants should press the spacebar to stop each video as soon as they could recognize the emotional expression, and then identify it from six provided labels/emotions. Greater eveningness was associated with shorter response times (RT) in the identification of sadness, disgust and happiness. Higher scores of expressive suppression were associated with longer RT in identifying sadness, disgust, anger and surprise. Expressive suppression significantly moderated the relationship between chronotype and the recognition of sadness and anger, with chronotype being a significant predictor of emotion recognition times only at higher levels of expressive suppression. No significant effects were observed for cognitive reappraisal. These results are consistent with a negative bias in emotion processing in late chronotypes and increased difficulty in anger and sadness recognition for expressive suppressor morning-types.
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Dinu M, Lotti S, Napoletano A, Corrao A, Pagliai G, Tristan Asensi M, Gianfredi V, Nucci D, Colombini B, Sofi F. Association between Psychological Disorders, Mediterranean Diet, and Chronotype in a Group of Italian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010335. [PMID: 36612656 PMCID: PMC9819730 DOI: 10.3390/ijerph20010335] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 05/30/2023]
Abstract
Mental health conditions are a significant contributor to the global burden of disease. The aim of this study was to explore the association between psychological disorders, Mediterranean diet (MD), and chronotype. A total of 344 participants (74% women) with a mean age of 33.5 ± 13 years were recruited. According to the Depression Anxiety Stress Scale (DASS-21) score, 22% of participants had symptoms of depression, 23% anxiety, and 10% stress. The assessment of MD adherence through the Medi-Lite score revealed that participants with psychological disorders had significantly (p < 0.05) lower MD adherence than those without these conditions. Furthermore, less than 10% of the subjects with at least one symptom reported consuming the optimal amount of fruit and vegetables, while 72% showed excessive consumption of meat and meat products. Regarding chronotype, evening subjects reported the lowest MD adherence and the highest prevalence of all three psychological disorders analyzed. A multivariate analysis showed that female gender, age, being unmarried/single, sedentary lifestyle, and low MD adherence were associated with a significantly higher risk of depression, anxiety, and stress. Future studies are needed to explore the relationship between mental health and risk factors to improve personal and global population health.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Sofia Lotti
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Antonia Napoletano
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Abigail Corrao
- Department of Human Science, Georgetown University, Washington, DC 20057, USA
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Marta Tristan Asensi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata, 64, 35128 Padua, Italy
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
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Zhu Y, Huang J, Yang M. Association between Chronotype and Sleep Quality among Chinese College Students: The Role of Bedtime Procrastination and Sleep Hygiene Awareness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010197. [PMID: 36612519 PMCID: PMC9820042 DOI: 10.3390/ijerph20010197] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 05/31/2023]
Abstract
Chronotype and sleep quality have been shown to play significant roles in influencing people's physical and mental health. The current study focuses on examining the relationship between chronotype and sleep quality among Chinese college students and exploring the mediating role of bedtime procrastination and the moderating role of sleep hygiene awareness. A sample of 2822 college students (female = 71.4%) aged between 17 and 29 years (M = 19.77, SD = 1.41) were included and completed the measures of the Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), Bedtime Procrastination Scale (BPS) and Sleep Hygiene Awareness Scale (SHAS). The results showed that evening-type students reported the lowest sleep quality and highest levels of bedtime procrastination. In contrast, the highest sleep quality and lowest levels of bedtime procrastination were shown by morning-type, exhibiting the neither-type students' intermediate chronotype. Bedtime procrastination partially mediated the relationship between chronotype and sleep quality. Furthermore, sleep hygiene awareness moderated the direct effect of chronotype on sleep quality and the effect of chronotype in the path from chronotype to bedtime procrastination. Specifically, higher levels of sleep hygiene awareness could buffer the adverse effect of chronotype on self-reported sleep quality but bolstered the negative effect of chronotype on bedtime procrastination. Our results suggest that individuals with an evening preference are inclined to postpone their bedtime and further experience poorer sleep quality at night. Sleep hygiene awareness may serve as a protective factor for poor nocturnal sleep. Overall, the findings highlight the importance of reducing bedtime procrastination and improving sleep hygiene awareness in the interventions designed to help college students to own a better sleep quality, especially for those with evening chronotypes.
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Affiliation(s)
- Yingying Zhu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
- Tianjin Social Science Laboratory of Students’ Mental Development and Learning, Tianjin 300387, China
| | - Jiahao Huang
- Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Minqi Yang
- School of Education, Zhengzhou University, Zhengzhou 450001, China
- School of Marxism, Zhengzhou University, Zhengzhou 450001, China
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Carciofo R. Morning affect, eveningness, and amplitude distinctness: Associations with behavioural indicators of conscientiousness. Chronobiol Int 2022; 39:1590-1600. [PMID: 36278268 DOI: 10.1080/07420528.2022.2134787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Morningness is associated with well-being, better sleep quality, and more conscientiousness, while eveningness is associated with negative emotionality, poorer sleep quality, and less conscientiousness. The current study aimed to further understanding of associations with conscientiousness by assessing specific behavioural indicators of conscientiousness, morningness-eveningness, and also the Morning Affect and Distinctness (amplitude of diurnal variation) aspects of circadian functioning. A survey of Chinese university students (N = 369, aged 18-30, mean = 19.48, SD = 1.922; 108 males, 261 females), included the Morningness-Eveningness-Stability-Scale, measures of conscientiousness, mindfulness, life satisfaction, aspects of sleep, and the Behavioural Indicators of Conscientiousness (BIC) scale. Morningness and Morning Affect were positively correlated with life satisfaction, mindfulness, better sleep quality, more conscientiousness, and with BIC including Hardworking, Self-control, and Punctuality. Distinctness showed negative correlations with these variables. Negative correlations between Eveningness and conscientiousness, and the BIC subscales of Hardworking and Cleanliness were no longer significant after controlling for Morning Affect. Mediation analysis showed that the associations between Eveningness and conscientiousness/BIC were mediated by Morning Affect. These results extend previous research by showing associations between circadian functioning and specific behavioural indicators of conscientiousness, and suggest that low Morning Affect may provide a mechanism for the relationship between Eveningness and conscientiousness.
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Affiliation(s)
- Richard Carciofo
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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62
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Low circadian amplitude and delayed phase are linked to seasonal affective disorder (SAD). JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Maternal Sleep Problems in the Periconceptional Period and the Impact on Health of Mother and Offspring: A Systematic Review. Clocks Sleep 2022; 4:688-713. [PMID: 36547103 PMCID: PMC9777334 DOI: 10.3390/clockssleep4040052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/06/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
Knowledge of the impact of sleep problems in the periconceptional period is scarce. Since this period is the most sensitive time window for embryonic and placental development, we aim to study the impact of maternal sleep problems in the periconceptional period on both mother and offspring. We systematically searched various databases up until September 2021 for studies reporting on maternal sleep in the periconceptional period and any outcome in mother and offspring. We included observational studies describing maternal sleep problems in the periconceptional period and associations with either maternal and/or offspring outcomes. The search produced 8596 articles, of which we selected 27 studies. Some associations were found between sleep problems and lower fertility, more hypertensive disorders, more mood disorders in mothers, higher risk of preterm birth and low birth weight, and more sleep and behavior problems in offspring, with associations with maternal mood disorders being most consistent. This systematic review shows that maternal sleep problems in the periconceptional period are associated with a higher risk of various adverse outcomes in both mother and offspring, although not consistently. It shows that good sleep during pregnancy is crucial, starting as early as before conception, especially for maternal mood. Therefore, it is important for clinicians to pay attention to sleep problems in the periconceptional period and provide adequate treatment for potential sleep problems, even before pregnancy.
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Jia Y, Wu Y, Jin T, Zhang L. How is circadian preference associated with cyber-victimization? A moderated mediation model of hostile recognition and online self-disclosure in Chinese early adolescent students. Front Psychol 2022; 13:970073. [DOI: 10.3389/fpsyg.2022.970073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Although circadian preference is widely accepted to be a risk factor in the increase of adolescents’ negative experiences, little is known about its association with cyber-victimization. The current study sought to examine whether eveningness was significantly related to adolescents’ negative experiences. We further examined in-victimization events and whether hostile recognition and online self-disclosure played a vital role in eveningness and adolescents’ cyber-victimization. Study participants included 583 adolescents from four middle schools in China who completed questionnaires regarding their circadian preference, hostile recognition, online self-disclosure, and experience with cyber-victimization. Results indicated that adolescents with a high level of eveningness were more likely to experience cyber-victimization. Hostile recognition significantly mediated the relationship between eveningness and adolescents’ cyber-victimization. Furthermore, online self-disclosure moderated the indirect relationship between eveningness and cyber-victimization. Specifically, the paths from eveningness to hostile recognition and from hostile recognition to cyber-victimization became strengthened when adolescents experienced high levels of online self-disclosure. The results imply that researchers should pay more attention to remote factors, such as adolescents’ circadian preference and their relationship with cyber-victimization, to help them adapt to school requirements and reduce the frequency of victimization.
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Associations Between Sleep Health and Amygdala Reactivity to Negative Facial Expressions in the UK Biobank Cohort. Biol Psychiatry 2022; 92:693-700. [PMID: 35933167 DOI: 10.1016/j.biopsych.2022.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Sleep health (SH) is considered a key determinant of human physiological and psychological well-being. In line with this, previous studies have found that poor sleep is associated with various psychiatric disorders, in particular, with anxiety and depression. Although little is known about the neural mechanisms underlying these associations, recent findings suggest that essential dimensions of SH are associated with altered amygdala reactivity (AR); however, evidence to date is inconsistent and reliant on small sample sizes. METHODS To address this problem, the current preregistered study investigated associations between SH and AR to negative facial expressions in the UK Biobank cohort (25,758 participants). Drawing on a large sample size and consistent data acquisition, 5 dimensions of SH (insomnia symptoms, sleep duration, daytime sleepiness, chronotype, and sleep medication) were examined. RESULTS Exploratory analyses revealed that short sleep duration was associated with decreased AR. The remaining SH dimensions and a composite measure of all SH dimensions were not associated with AR. CONCLUSIONS To our knowledge, this is the largest study to test associations between SH and AR. Habitual short sleep duration may be associated with decreased AR, possibly indicating compensation for impaired prefrontal processes and hampered emotion regulation.
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Seo JY, Yeom JW, Cho CH, Son S, Ahn YM, Kim SJ, Ha TH, Cha B, Moon E, Park DY, Baek JH, Kang HJ, An H, Lee HJ. The relationship between morningness-eveningness and mood symptoms and quality of life in euthymic state of mood disorders: Results from a prospective observational cohort study. J Affect Disord 2022; 316:10-16. [PMID: 35940376 DOI: 10.1016/j.jad.2022.07.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND The clinical importance of morningness-eveningness, especially in mood disorders, is prevailing. The differential relation of chronotype with diagnoses of early-onset mood disorders, mood symptoms, anxiety, and quality of life was evaluated. METHODS Early-onset mood disorder patients [n = 419; 146 major depressive disorder (MDD); 123 bipolar I disorder (BDI); 150 bipolar II disorder (BDII)] from the Mood Disorder Cohort Research Consortium were assessed for chronotype using the composite scale for morningness (CSM) and its association with clinical variables obtained during the clinician-verified euthymic state. RESULTS The mean total CSM of BDI was significantly higher than MDD and BDII (p < 0.001). In all types of mood disorders, higher total CSM was associated with lower Quick inventory of depressive symptomatology (p < 0.005) and higher WHO quality of life (p < 0.005). Such negative correlations between the total CSM and Montgomery-Asberg depression rating were significant in MDD and BDI (p < 0.05) and marginally significant in BDII (p = 0.077). CSM was a significant contributor to quality of life in BDI (p < 0.001) and BDII (p = 0.011), but it was not for MDD. LIMITATIONS The defined 'euthymic state' that may not fully reflect the remission of episode; limited generalizability due to clinical characteristic of early-onset mood disorder; the disparity between diurnal preference measured by the CSM and chronotype; possible effects of the last mood episode polarity and medication; and, lack of control group. CONCLUSION Less eveningness was associated with less severe depressive symptoms and better quality of life. This suggests that morningness may reduce residual depressive symptoms and recover function of patients.
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Affiliation(s)
- Ju Yeon Seo
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea; Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Ji Won Yeom
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea; Chronobiology Institute, Korea University, Seoul, Republic of Korea
| | - Chul-Hyun Cho
- Chronobiology Institute, Korea University, Seoul, Republic of Korea; Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea; Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Serhim Son
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Min Ahn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Se Joo Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Eunsoo Moon
- Department of Psychiatry, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Dong Yeon Park
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University College of Medicine, Gwangju, Republic of Korea
| | - Hyonggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Biomedical Science, Korea University College of Medicine, Seoul, Republic of Korea; Chronobiology Institute, Korea University, Seoul, Republic of Korea.
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Heikkala E, Paananen M, Merikanto I, Karppinen J, Oura P. Eveningness intensifies the association between musculoskeletal pain and health-related quality of life: a Northern Finland Birth Cohort Study 1966. Pain 2022; 163:2154-2161. [PMID: 35135992 PMCID: PMC9578528 DOI: 10.1097/j.pain.0000000000002609] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/16/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT People with an evening (E)-type preference (ie, chronotype) experience musculoskeletal (MSK) pain and reduced health-related quality of life (HRQoL) more often than morning (M) types. Musculoskeletal pain is a well-established contributor to reduced HRQoL. This study aimed to evaluate whether eveningness amplifies the association between MSK pain and HRQoL in contrast to morningness. Questionnaire data on MSK pain dimensions (intensity, disability at work, number of pain sites [NPSs], and frequency), chronotype, covariates (sex, sufficiency of sleep duration, mental distress, and presence of coexisting diseases), and HRQoL (measured by 15D) were collected among 46-year-old individuals belonging to the Northern Finland Birth Cohort 1966 (N = 4257). Individuals without any MSK pain were excluded. General linear models were conducted to estimate the associations between chronotypes, MSK pain dimensions, and HRQoL. The interaction terms (chronotype × pain dimension) were tested in the models. There were 13% E-types and 43% M-types in the study sample. Each pain dimension and chronotype were related to HRQoL. In the sex-adjusted chronotype-specific models, the reduction in HRQoL in relation to pain appeared to be stronger among E-types than among M-types in respect to all pain dimensions. After adjustments, this was particularly seen in terms of NPS and pain frequency. Our findings suggest that eveningness intensifies the association between MSK pain and HRQoL, and, thus, they are indicative of E-types being more sensitive than M-types to the consequences of MSK pain. As such, MSK pain treatment and rehabilitation actions to improve HRQoL should be especially targeted at E-types.
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Affiliation(s)
- Eveliina Heikkala
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Rovaniemi Health Center, Rovaniemi, Finland
| | - Markus Paananen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Primary Health Care Services, City of Espoo, Espoo, Finland
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Jaro Karppinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
| | - Petteri Oura
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Finland
- Department of Forensic Medicine, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Forensic Medicine Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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68
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Mun CJ, Burgess HJ, Sears DD, Parthasarathy S, James D, Altamirano U, Sajith S, Lakhotia A, Fillingim RB, Youngstedt SD. Circadian Rhythm and Pain: a Review of Current Research and Future Implications. CURRENT SLEEP MEDICINE REPORTS 2022. [DOI: 10.1007/s40675-022-00228-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Díaz-Morales JF, Puig-Navarro Y. The psychometric properties of the Spanish version of the Morningness-Eveningness Stability Scale improved (MESSi) in adolescents. Chronobiol Int 2022; 39:1411-1418. [PMID: 36039013 DOI: 10.1080/07420528.2022.2115378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of the present study was to adapt the Morningness-Eveningness-Stability Scale improved (MESSi) to the Spanish adolescent population, testing its factor structure and construct validity. The participants were 725 adolescents (52.9% girls; M = 14.8, SD = 1.99) who completed the MESSi, the Morningness Eveningness Scale of Children (MESC), questions about sleep habits adapted from the School Sleep Habits Survey, and self-reported academic performance. The psychometric results support a three-factor model with the factors of morning affect, eveningness, and distinctness, which show good internal consistency. The pattern of correlations between MESSi and the other measures was in the expected direction. The MESC correlated positively with morning affect and negatively with eveningness, whereas distinctness was uncorrelated. Boys reported higher morningness, whereas girls reported higher distinctness. Eveningness was negatively related to academic performance. Overall, the results support the validity and reliability of the Spanish adolescent version of the MESSi.
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Affiliation(s)
- Juan F Díaz-Morales
- Faculty of Psychology, Complutense University of Madrid Social PsychologySpain
| | - Yaiza Puig-Navarro
- Faculty of Psychology, Complutense University of Madrid Social PsychologySpain
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70
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Zou H, Zhou H, Yan R, Yao Z, Lu Q. Chronotype, circadian rhythm, and psychiatric disorders: Recent evidence and potential mechanisms. Front Neurosci 2022; 16:811771. [PMID: 36033630 PMCID: PMC9399511 DOI: 10.3389/fnins.2022.811771] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/21/2022] [Indexed: 12/27/2022] Open
Abstract
The circadian rhythm is crucial for physiological and behavioral functions. Chronotype, which represents individual preferences for activity and performance, is associated with human health issues, particularly psychiatric disorders. This narrative review, which focuses on the relationship between chronotype and mental disorders, provides an insight into the potential mechanism. Recent evidence indicates that (1) the evening chronotype is a risk factor for depressive disorders and substance use disorders, whereas the morning chronotype is a protective factor. (2) Evening chronotype individuals with bipolar disorder tend to have more severe symptoms and comorbidities. (3) The evening chronotype is only related to anxiety symptoms. (4) The relationship between chronotype and schizophrenia remains unclear, despite increasing evidence on their link. (5) The evening chronotype is significantly associated with eating disorders, with the majority of studies have focused on binge eating disorders. Furthermore, the underlying mechanisms or influence factors are described in detail, including clock genes, brain characteristics, neuroendocrinology, the light/dark cycle, social factors, psychological factors, and sleep disorders. These findings provide the latest evidence on chronotypes and psychiatric disorders and serve as a valuable reference for researchers.
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Affiliation(s)
- Haowen Zou
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hongliang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui Yan
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhijian Yao
- Nanjing Brain Hospital, Medical School, Nanjing University, Nanjing, China
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, Nanjing, China
- Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing, China
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71
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Yilbas B, Ozturk HI, Karadeniz PG. The relationship of chronotypes with food addiction, impulsivity, and attention deficit hyperactivity disorder symptoms in a sample of undergraduate university students. Chronobiol Int 2022; 39:1389-1398. [PMID: 35938448 DOI: 10.1080/07420528.2022.2109483] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The primary aim of the current study was to examine the frequency of food addiction in a group of university students and whether it differed among chronotypes. The second aim was to investigate the relationship of chronotypes with impulsivity, poor sleep quality and attention deficit/ hyperactivity disorder (ADHD) symptoms and to evaluate how this relationship affects food addiction. 328 university students were included in the study. Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale (ASRS), Morningness-Eveningness Questionnaire (MEQ), Barratt Impulsiveness Scale-11 Short Form (BIS-11-SF), Yale Food Addiction Scale (YFAS) and Pittsburgh Sleep Quality Index (PSQI) were administered. Evening types scored significantly higher on ASRS and BIS-11 SF (p < .001, p < .001 respectively). Based on YFAS scores, 12.5% (n = 41) of the participants met the criteria for food addiction. The number of participants fulfilling the criteria for food addiction was higher among the evening types compared to intermediate and morning types (p = .006, p = .004, respectively). The mean ASRS and BIS-11 SF scores of the students who met the criteria for food addiction were significantly greater than those who did not (p < .001, p < .001, respectively). 63.4% (n = 26) of the students meeting the criteria for food addiction scored 6 or higher on PSQI versus 32.0% (n = 92) of the students who did not (p < .001). Mediation analysis showed that the direct effect of MEQ scores on food addiction was not significant (β = -0.009, p = .723). However, lower MEQ scores had an indirect effect on food addiction through higher ASRS scores (β = -0.027; p < .05 bias corrected and accelerated 95% CI -0.052 to -0.011). The results of the present study suggest that higher prevalence of food addiction among evening types seems to be related to higher occurrence of ADHD symptoms in these chronotypes. Further population-based studies with a larger sample size are needed to confirm our findings.
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Affiliation(s)
- Baris Yilbas
- Department of Psychiatry, SANKO University School of Medicine, Gaziantep, Turkey
| | - Halil Ibrahim Ozturk
- Department of Psychiatry, SANKO University School of Medicine, Gaziantep, Turkey
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Ma Y, Zhang B, Meng Y, Cao Y, Mao Y, Qiu C. Perceived stress and depressive symptoms among Chinese college students: A moderated mediation model of biorhythm and ego resilience. Front Public Health 2022; 10:951717. [PMID: 35991064 PMCID: PMC9386344 DOI: 10.3389/fpubh.2022.951717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To explore whether biological rhythm disturbance mediates the association between perceived stress and depressive symptoms and to investigate whether ego resilience moderates the mediation model. Methods A cross-sectional study was carried out using an online self-report questionnaire distributed to college students from September 2021 to October 2021. Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Severity (PSS-10), the Biological Rhythms Assessment in Neuropsychiatry (BRIAN), and Ego Resilience (ER-96) were used for investigation. SPSS 23 was used for data analyses. The significance of mediation was determined by the PROCESS macro using a bootstrap approach. Results Among the participants, 9.2% (N = 1,282) exhibited significant symptoms of depression. Perceived stress was positively associated with depressive symptoms, and biorhythm partially mediated this relationship. The direct and indirect effects were both moderated by ego resilience. Perceived stress had a greater impact on depressive symptoms and biorhythm for college students with lower ego resilience, and the impact of biorhythm on depressive symptoms was also stronger for those with lower ego resilience. Perceived stress had an impact on depressive symptoms directly and indirectly via the mediation of biorhythm. Conclusion Schools and educators should guide college students to identify stress correctly and provide effective suggestions to deal with it. Meanwhile, maintaining a stable biorhythm can protect college students from developing depressive symptoms. Students with low resilience should be given more attention and assistance.
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Affiliation(s)
- Yao Ma
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Baiyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yajing Meng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Cao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yineng Mao
- School of Public Health, North Sichuan Medical College, Nanchong, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Changjian Qiu
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73
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Freff J, Beins EC, Bröker L, Schwarte K, Leite Dantas R, Maj C, Arolt V, Dannlowski U, Nöthen MM, Baune BT, Forstner AJ, Alferink J. Chemokine receptor 4 expression on blood T lymphocytes predicts severity of major depressive disorder. J Affect Disord 2022; 310:343-353. [PMID: 35526724 DOI: 10.1016/j.jad.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chemokines and their receptors regulate inflammatory processes in major depressive disorder (MDD). Here, we characterize the expression pattern of the C-C chemokine receptor 4 (CCR4) and its ligands CCL17 and CCL22 in MDD and its clinical relevance in predicting disease severity. METHODS Expression of CCR4 on peripheral blood lymphocytes and serum CCL17/CCL22 levels were measured using multiparameter flow cytometry and multiplex assays in 33 depressed inpatients at baseline (T0) and after 6-week multimodal treatment (T1) compared with 21 healthy controls (HC). Using stratified and correlation analysis, we examined the associations of CCR4-CCL17/CCL22 expression with depression severity and symptoms according to standard clinical rating scales and questionnaires. Additionally, we assessed whether polygenic risk score (PRS) for psychiatric disorders and chronotype are associated with disease status or CCR4-CCL17/CCL22 expression. Regression analysis was performed to assess the capacity of CCR4 and PRS in predicting disease severity. RESULTS Compared with HC, MDD patients showed significantly decreased CCR4 expression on T cells (T0 and T1), whereas CCL17/CCL22 serum levels were increased. Stratified and correlation analysis revealed an association of CCR4 expression on CD4+ T cells with depression severity as well as Beck Depression Inventory-II items including loss of pleasure, agitation and cognitive deficits. CCR4 expression levels on CD4+ T cells together with cross-disorder and chronotype PRS significantly predicted disease severity. LIMITATIONS This exploratory study with small sample size warrants future studies. CONCLUSIONS This newly identified CCR4-CCL17/CCL22 signature and its predictive capacity for MDD severity suggest its potential functional involvement in the pathophysiology of MDD.
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Affiliation(s)
- Jana Freff
- Department of Psychiatry, University of Münster, Münster, Germany; Cells in Motion Interfaculty Cluster, University of Münster, Münster, Germany.
| | - Eva C Beins
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.
| | - Lisa Bröker
- Department of Psychiatry, University of Münster, Münster, Germany; Cells in Motion Interfaculty Cluster, University of Münster, Münster, Germany.
| | - Kathrin Schwarte
- Department of Psychiatry, University of Münster, Münster, Germany.
| | - Rafael Leite Dantas
- Department of Psychiatry, University of Münster, Münster, Germany; Cells in Motion Interfaculty Cluster, University of Münster, Münster, Germany.
| | - Carlo Maj
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany; Centre for Human Genetics, University of Marburg, Marburg, Germany.
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany.
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany.
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany.
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany; Centre for Human Genetics, University of Marburg, Marburg, Germany; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany.
| | - Judith Alferink
- Department of Psychiatry, University of Münster, Münster, Germany; Cells in Motion Interfaculty Cluster, University of Münster, Münster, Germany.
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Salfi F, D'Atri A, Amicucci G, Viselli L, Gorgoni M, Scarpelli S, Alfonsi V, Ferrara M. The fall of vulnerability to sleep disturbances in evening chronotypes when working from home and its implications for depression. Sci Rep 2022; 12:12249. [PMID: 35851068 PMCID: PMC9293935 DOI: 10.1038/s41598-022-16256-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/07/2022] [Indexed: 01/18/2023] Open
Abstract
Eveningness is distinctively associated with sleep disturbances and depression symptoms due to the misalignment between biological and social clocks. The widespread imposition of remote working due to the COVID-19 pandemic allowed a more flexible sleep schedule. This scenario could promote sleep and mental health in evening-type subjects. We investigated the effect of working from home on sleep quality/quantity and insomnia symptoms within the morningness-eveningness continuum, and its indirect repercussions on depressive symptomatology. A total of 610 Italian office workers (mean age ± standard deviation, 35.47 ± 10.17 years) and 265 remote workers (40.31 ± 10.69 years) participated in a web-based survey during the second contagion wave of COVID-19 (28 November–11 December 2020). We evaluated chronotype, sleep quality/duration, insomnia, and depression symptoms through validated questionnaires. Three moderated mediation models were performed on cross-sectional data, testing the mediation effect of sleep variables on the association between morningness-eveningness continuum and depression symptoms, with working modality (office vs. remote working) as moderator of the relationship between chronotype and sleep variables. Remote working was associated with delayed bedtime and get-up time. Working modality moderated the chronotype effect on sleep variables, as eveningness was related to worse sleep disturbances and shorter sleep duration among the office workers only. Working modality also moderated the mediation of sleep variables between chronotype and depression. The above mediation vanished among remote workers. The present study suggests that evening-type people did not show their characteristic vulnerability to sleep problems when working from home. This result could imply a reduction of the proposed sleep-driven predisposition to depression of late chronotypes. A working environment complying with individual circadian preferences might ensure an adequate sleep quantity/quality for the evening-type population, promoting their mental health.
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Affiliation(s)
- Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Aurora D'Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giulia Amicucci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Viselli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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Chan JW, Lam SP, Li SX, Chau SW, Chan SY, Chan NY, Zhang JH, Wing YK. Adjunctive bright light treatment with gradual advance in unipolar major depressive disorder with evening chronotype - A randomized controlled trial. Psychol Med 2022; 52:1448-1457. [PMID: 32924897 DOI: 10.1017/s0033291720003232] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Unipolar non-seasonal depressed patients with concomitant evening chronotype were associated with poor clinical outcomes and higher non-remission rate. This study aims to examine the efficacy of adjunctive bright light therapy with gradual timing advance in a randomized, assessor and prescriber-blinded controlled trial. METHOD Participants were randomly allocated to receive 5 weeks of either bright white light therapy (BLT) or dim red light (DRL) with the same advancement protocol. Participants were followed up till 5 months after treatment. Primary outcomes included (i) remission rate and (ii) the severity of depression. The analysis was conducted using Kaplan-Meier survival analysis, Cox proportional hazard analysis and linear mixed models. RESULTS A total of 93 participants (46.4 ± 11.7 years old, 80% female) were randomized. The cumulative remission rate for the BLT and the DRL groups was 67.4% and 46.7%, respectively. Time to remission was shorter for the BLT group relative to the DRL group (log-rank test p = 0.024). Cox proportional hazard survival analysis showed that patients in the BLT group had a higher probability of achieving remission relative to patients in the DRL group [hazard ratio = 1.9 (95% CI = 1.1- 3.4), p = 0.026]. Further sensitivity analysis demonstrated greater improvement in 17-Hamilton Depression Score (group × time interaction, p = 0.04) in the BLT group for those who were adherent to light therapy. CONCLUSIONS The use of bright light therapy with gradual advance protocol is an effective adjunctive treatment resulting in quicker and a higher rate of remission of depression in patients with non-seasonal unipolar depression and evening-chronotype.
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Affiliation(s)
- Joey Wy Chan
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - S P Lam
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Shirley X Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Steven Wh Chau
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - S Y Chan
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - N Y Chan
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - J H Zhang
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
| | - Y K Wing
- Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, China
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Almeida F, Pires L, Bettencourt C, Almeida R, Ruivo Marques D, Leitão J, Gomes AA. Momentary emotional states in primary school children: combined effects of chronotype X time-of-day. BIOL RHYTHM RES 2022. [DOI: 10.1080/09291016.2022.2081400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Filipa Almeida
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
| | - Luís Pires
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Memory, Language and Executive Functions Lab, University of Coimbra, Coimbra, Portugal
- Department of Psychology, School of Life Sciences, University of Hull, UK
| | - Catarina Bettencourt
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
| | - Rita Almeida
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
| | - Daniel Ruivo Marques
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - José Leitão
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Memory, Language and Executive Functions Lab, University of Coimbra, Coimbra, Portugal
| | - Ana Allen Gomes
- Faculty of Psychology and Educational Sciences, University Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, Portugal
- Memory, Language and Executive Functions Lab, University of Coimbra, Coimbra, Portugal
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77
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Dama M, Khoo Y, Frey BN, Milev RV, Ravindran AV, Parikh SV, Rotzinger S, Lou W, Lam RW, Kennedy SH, Bhat V. Rhythmicity of sleep and clinical outcomes in major depressive disorder: A CAN-BIND-1 Report. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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78
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Saito T, Suzuki H, Kishi A. Predictive Modeling of Mental Illness Onset Using Wearable Devices and Medical Examination Data: Machine Learning Approach. Front Digit Health 2022; 4:861808. [PMID: 35493532 PMCID: PMC9046696 DOI: 10.3389/fdgth.2022.861808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022] Open
Abstract
The prevention and treatment of mental illness is a serious social issue. Prediction and intervention, however, have been difficult because of lack of objective biomarkers for mental illness. The objective of this study was to use biometric data acquired from wearable devices as well as medical examination data to build a predictive model that can contribute to the prevention of the onset of mental illness. This was an observational study of 4,612 subjects from the health database of society-managed health insurance in Japan provided by JMDC Inc. The inputs to the predictive model were 3-months of continuous wearable data and medical examinations within and near that period; the output was the presence or absence of mental illness over the following month, as defined by insurance claims data. The features relating to the wearable data were sleep, activity, and resting heart rate, measured by a consumer-grade wearable device (specifically, Fitbit). The predictive model was built using the XGBoost algorithm and presented an area-under-the-receiver-operating-characteristic curve of 0.712 (SD = 0.02, a repeated stratified group 10-fold cross validation). The top-ranking feature importance measure was wearable data, and its importance was higher than the blood-test values from medical examinations. Detailed verification of the model showed that predictions were made based on disrupted sleep rhythms, mild physical activity duration, alcohol use, and medical examination data on disrupted eating habits as risk factors. In summary, the predictive model showed useful accuracy for grouping the risk of mental illness onset, suggesting the potential of predictive detection, and preventive intervention using wearable devices. Sleep abnormalities in particular were detected as wearable data 3 months prior to mental illness onset, and the possibility of early intervention targeting the stabilization of sleep as an effective measure for mental illness onset was shown.
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Affiliation(s)
| | | | - Akifumi Kishi
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
- *Correspondence: Akifumi Kishi
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79
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Chronodisruption and diet associated with increased cardiometabolic risk in coronary heart disease patients: the CORDIOPREV study. Transl Res 2022; 242:79-92. [PMID: 34752950 DOI: 10.1016/j.trsl.2021.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/20/2023]
Abstract
Individuals with evening chronotypes are prone to suffer chronodisruption and display worse lifestyle habits than morning-types, exhibiting higher cardiovascular diseases (CVD). However, it is unknown whether CVD patients, who are evening chronotypes, have higher cardiometabolic risk than morning-types. This study explored whether individual chronotypes were associated with cardiometabolic risk in patients from the CORDIOPREV study (n = 857). We also investigated whether potential associations were moderated by long-term consumption of two healthy diets (Mediterranean and Low-fat diets). This population was classified into chronotypes using the Morningness-Eveningness Questionnaire. Seven-day daily rhythms in wrist temperature (T), rest-activity (A) and position (P) were recorded in a subset of patients (n = 168), and an integrative variable TAP was determined. Metabolic Syndrome (MetS) was determined at baseline, and metabolic and inflammation markers were measured at baseline and yearly during the 4 years of follow-up. Differences in several lifestyle factors were analyzed according to chronotype. At all times, evening-types had higher triglycerides, C-reactive protein and homocysteine and lower high density lipoprotein cholesterol than morning-types (P < 0.05). Evening-types had a higher prevalence of MetS (OR 1.58 IC 95% [1.10 - 2.28], P = 0.01). Moreover, they were more sedentary, displayed less and delayed physical activity and ate and slept later. In addition, evening-types had lower amplitude, greater fragmentation, lower robustness and less stable circadian pattern at TAP (P < 0.01), all related to a less healthy circadian pattern. In conclusion, evening-types with CVD had higher cardiometabolic risk and less robust circadian-related rhythms than morning-types, regardless of the nutritional intervention.
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80
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Zafar A, Overton R, Attia Z, Ay A, Ingram K. Machine learning and expression analyses reveal circadian clock features predictive of anxiety. Sci Rep 2022; 12:5508. [PMID: 35365695 PMCID: PMC8975926 DOI: 10.1038/s41598-022-09421-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Abstract
Mood disorders, including generalized anxiety disorder, are associated with disruptions in circadian rhythms and are linked to polymorphisms in circadian clock genes. Molecular mechanisms underlying these connections may be direct-via transcriptional activity of clock genes on downstream mood pathways in the brain, or indirect-via clock gene influences on the phase and amplitude of circadian rhythms which, in turn, modulate physiological processes influencing mood. Employing machine learning combined with statistical approaches, we explored clock genotype combinations that predict risk for anxiety symptoms in a deeply phenotyped population. We identified multiple novel circadian genotypes predictive of anxiety, with the PER3(rs17031614)-AG/CRY1(rs2287161)-CG genotype being the strongest predictor of anxiety risk, particularly in males. Molecular chronotyping, using clock gene expression oscillations, revealed that advanced circadian phase and robust circadian amplitudes are associated with high levels of anxiety symptoms. Further analyses revealed that individuals with advanced phases and pronounced circadian misalignment were at higher risk for severe anxiety symptoms. Our results support both direct and indirect influences of clock gene variants on mood: while sex-specific clock genotype combinations predictive of anxiety symptoms suggest direct effects on mood pathways, the mediation of PER3 effects on anxiety via diurnal preference measures and the association of circadian phase with anxiety symptoms provide evidence for indirect effects of the molecular clockwork on mood. Unraveling the complex molecular mechanisms underlying the links between circadian physiology and mood is essential to identifying the core clock genes to target in future functional studies, thereby advancing the development of non-invasive treatments for anxiety-related disorders.
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Affiliation(s)
- Aziz Zafar
- Department of Biology, Colgate University, 13 Oak Drive, Hamilton, NY, 13346, USA
| | - Rebeccah Overton
- Department of Biology, Colgate University, 13 Oak Drive, Hamilton, NY, 13346, USA
| | - Ziad Attia
- Department of Biology, Colgate University, 13 Oak Drive, Hamilton, NY, 13346, USA
| | - Ahmet Ay
- Department of Biology, Colgate University, 13 Oak Drive, Hamilton, NY, 13346, USA.
| | - Krista Ingram
- Department of Biology, Colgate University, 13 Oak Drive, Hamilton, NY, 13346, USA.
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81
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Ashi K, Levey E, Friedman LE, Sanchez SE, Williams MA, Gelaye B. Association of morningness-eveningness with psychiatric symptoms among pregnant women. Chronobiol Int 2022; 39:984-990. [PMID: 35296206 DOI: 10.1080/07420528.2022.2053703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In the present study, we examined associations between circadian preference and psychiatric symptoms among 1,796 pregnant women from Lima, Peru. One quarter were classified as evening types. Compared to morning types, evening type pregnant women had increased odds of generalized anxiety (OR = 1.44; 95%CI: 1.12-1.86) and posttraumatic stress disorder (OR = 1.38; 95%CI: 1.07-1.78). Although there was a positive trend, evening chronotype was not significantly associated with elevated odds of depression (OR = 1.23; 95%CI: 0.94-1.61). Future studies are warranted to help understand the underlying behavioral, biological, and genetic pathways of these associations. Assessing circadian preference may help clinicians identify pregnant women at risk for psychiatric symptoms.
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Affiliation(s)
- Kevin Ashi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Levey
- The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren E Friedman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sixto E Sanchez
- Asociación Civil Proyectos en Salud (PROESA), Lima, Peru.,Facultad de Medicina, Universidad de San Martin de Porres, Lima, Peru
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,The Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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82
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Mokros L, Nowakowska-Domagała K, Witusik A, Pietras T. Evening chronotype as a bipolar feature among patients with major depressive disorder: the results of a pilot factor analysis. BRAZILIAN JOURNAL OF PSYCHIATRY 2022; 44:35-40. [PMID: 35170673 PMCID: PMC8827374 DOI: 10.1590/1516-4446-2021-1747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
Objectives: The bipolar spectrum concept has resulted in a paradigm shift that has affected both the diagnosis and therapy of mood disorders, with bipolarity becoming an indicator of treatment resistance in depression. Evening circadian preference has also been linked to affective disorders. The aim of our study was to confirm the relationship between the severity of depressive symptoms, bipolar features, chronotype, and sleep quality among patients with major depressive disorder. Methods: A group of 55 individuals who were recruited from a mental health outpatient clinic completed the following psychometric tools: a Chronotype Questionnaire comprising morningness-eveningness (ME) and subjective amplitude of the rhythm (AM) scales, the Hypomania Checklist 32 (HCL-32), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI). Results: Factor analysis identified two latent components, accounting cumulatively for 58% of variables: depressive symptoms (BDI and PSQI) and bipolarity (ME, AM, and HCL-32). After rotation, ME loading in the first factor increased the result to a significant level. The correlation between the two components was very low. Conclusions: Evening chronotype appears to be a bipolarity-related marker, with this relationship being independent of its link to depressive symptoms and sleep quality. Eveningness and high circadian rhythm amplitude may offer promise as diagnostic, prognostic, and therapeutic predictors.
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Affiliation(s)
- Lukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | | | - Andrzej Witusik
- Music Therapy Course, Faculty of Composition, Theory of Music, Conducting, Eurhythmics and Music Education, Grazyna and Kiejstut Bacewicz Memorial Academy of Music in Lódź, Lodz, Poland
| | - Tadeusz Pietras
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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83
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Ricketts EJ, Montalbano GE, Burgess HJ, McMakin DL, Coles ME, Piacentini J, Colwell CS. Sleep and chronotype in adults with persistent tic disorders. J Clin Psychol 2022; 78:1516-1539. [PMID: 35150595 DOI: 10.1002/jclp.23323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/22/2021] [Accepted: 01/14/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This study examined sleep disorders and sleep medication use rates, nighttime tics, and sleep and chronotype in relation to tic and co-occurring symptoms in adults with persistent tic disorders (PTDs), including Tourette's disorder (TD). METHODS One hundred twenty-five adult internet survey respondents rated sleep history, sleep, chronotype, tic severity, impairment, attention deficit hyperactivity disorder, obsessive-compulsive symptoms, anxiety, depression, and emotional and behavioral dyscontrol. RESULTS Bruxism, insomnia, tic-related difficulty falling asleep, and melatonin use were commonly endorsed. Sleep disturbance correlated with impairment, obsessive-compulsive symptoms, and emotional and behavioral dyscontrol. Eveningness correlated with vocal and total tic severity only in TD. Controlling for age and sex, age, impairment, and obsessive-compulsive symptoms predicted sleep disturbance, and age and tic severity predicted chronotype. CONCLUSIONS Impairment and obsessive-compulsive symptoms play a role in sleep disturbance in adults with PTDs, and may be intervention targets. Eveningness relates to tic severity, which may suggest the utility of interventions to advance chronotype.
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Affiliation(s)
- Emily J Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Gabrielle E Montalbano
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, Florida, USA.,Department of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA
| | - Meredith E Coles
- Department of Psychology, State University of New York-Binghamton, Binghamton, New York, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - Christopher S Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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84
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Hasan MM, Díaz-Morales JF, Khan MHA. Sex differences in the relationship between morningness-eveningness components, mood and well-being among Bangladeshi university students. Chronobiol Int 2022; 39:725-734. [PMID: 35109733 DOI: 10.1080/07420528.2022.2032126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
On the Morningness/Eveningness (M/E) continuum, eveningness has been related to mood disorder and poor well-being. M/E differs between men and women throughout their lifespan. However, there is a lack of information on sex differences in the relationship between M/E, mood, and well-being. This study aimed to test sex differences in the M/E, mood, and well-being relationship with consideration of two components of M/E, morning affect, and morning preference. A sample of 981 Bangladeshi university students (607 men) aged 18 to 27 (M = 21.95) completed Bangla versions of the Composite Scale of Morningness (CSM), BRUnel Mood Scale (BRUMS), and Positive Mental Health scale (PMH-scale) through an online survey. Multiple regression analyses were used to test the relationship of M/E components with mood and well-being. The results showed that the relationship between M/E, mood, and well-being was greater in women than in men. A lower score on both M/E components was related to higher negative moods (anger, confusion, depression, fatigue, and tension) and poor well-being. In regression analysis, only morning affect was found to be significant, which means that morning affect mainly contributes to the relation between M/E, mood, and well-being. Finally, sex by morning affect interaction indicated that the relation was higher for women. Therefore, higher eveningness could be more hazardous for women than men. Greater insight into the independent contribution of morning affect may facilitate understanding of the chronotype effects on psychological outcomes in men and women.
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Affiliation(s)
- M Mahmudul Hasan
- Department of Psychology, University of Rajshahi, Rajshahi, Bangladesh.,Institute of Bangladesh Studies, University of Rajshahi, Rajshahi, Bangladesh
| | - Juan F Díaz-Morales
- Individual Differences, Work and Social Psychology Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, Madrid, Spain
| | - Mozibul H A Khan
- Department of Psychology, University of Rajshahi, Rajshahi, Bangladesh
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85
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Chan JW, Chan NY, Li SX, Lam SP, Chau SWH, Liu Y, Zhang J, Wing YK. Change in circadian preference predicts sustained treatment outcomes in patients with unipolar depression and evening preference. J Clin Sleep Med 2022; 18:523-531. [PMID: 34534071 PMCID: PMC8805013 DOI: 10.5664/jcsm.9648] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES Eveningness is associated with worse outcomes in depression. It remained unclear if eveningness could be altered with chronobiological therapy and whether such a change would predict long-term outcomes of depression. METHODS Data from a randomized controlled trial of 5-week adjunctive bright light therapy with a gradual advance protocol conducted in 91 adult patients with nonseasonal unipolar depression and eveningness (Morningness-Eveningness Questionnaire, score ≤ 41) was examined. "Change of eveningness" was defined by Morningness-Eveningness Questionnaire score over 41 at posttreatment week 5 and "persistent change of eveningness" was defined as maintenance of Morningness-Eveningness Questionnaire score > 41 throughout the follow-up period from week 5 to posttreatment 5 months. RESULTS Thirty-three participants (36%) had change of eveningness at week 5. Generalized estimating equations models showed that a change of eveningness at week 5 predicted a 2-fold increase in remission of depression over the 5-month follow up (odds ratio = 2.61 95% confidence interval 1.20-5.71, P = .016). Twenty-five participants (75.7%) had a persistent change and were more likely to achieve a remission of depression over the 5-month follow up (odds ratio = 3.18, 95% confidence interval: 1.35-7.50, P = .008). CONCLUSIONS One-third of the patients with depression changed their evening-preference after 5-week of chronotherapeutic treatment, and such change predicted a higher likelihood of depression remission over 5 months of follow-up. CLINICAL TRIAL REGISTRATION Registry: Chinese Clinical Trial Registry; Name: Adjunctive light treatment in major depressive disorder patients with evening chronotype-A randomized controlled trial; URL: https://www.chictr.org.cn/showprojen.aspx?proj=11672; Identifier: ChiCTR-IOR-15006937. CITATION Chan JWY, Chan NY, Li SX, et al. Change in circadian preference predicts sustained treatment outcomes in patients with unipolar depression and evening preference. J Clin Sleep Med. 2022;18(2):523-531.
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Affiliation(s)
- Joey W.Y. Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region,Address correspondence to: Joey W.Y. Chan, FHKAM (Psych), Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; Tel: (852)39197593; Fax: (852)26475321;
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region
| | - Siu Ping Lam
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Steven Wai Ho Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region,Guangdong Mental Health Center, Guangdong Provincial People’s Hospital, Guangdong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
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86
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Cheung FTW, Ho AWY, Chan JWY, Li X, Chan NY, Zhang J, Ho CS, Wing YK, Li SX. Validation of the Chinese version of the Munich Chronotype Questionnaire (MCTQ HK) in Hong Kong Chinese youths. Chronobiol Int 2022; 39:678-689. [PMID: 35086397 DOI: 10.1080/07420528.2022.2025821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Chronotype, referred to as an individual's diurnal preference of timing for rest and activity, can be subjectively measured using the Munich Chronotype Questionnaire (MCTQ). However, the validity of MCTQ has yet to be tested in the youth population. In addition, it remains uncertain if MCTQ is a good measure of chronotype in individuals with insomnia. The current study aimed to validate the Chinese version of MCTQ (MCTQHK) in the youth population and to explore the utility of MCTQHK in individuals with insomnia. The original MCTQ was translated into Chinese language using the translation-back-translation method. Part one of this study included 988 youths who completed a battery of self-report questionnaires online consisting of the MCTQHK and the morningness-eveningness questionnaire (MEQ) for the measures of circadian preference, Insomnia Severity Index (ISI) to assess insomnia symptoms, and Patient Health Questionnaire (PHQ-9) to measure depressive symptoms. Test-retest reliability was examined in 442 participants at one-month follow-up. Of the overall sample, 69 participants were randomly drawn to complete the second part of the study, which included prospective 7-day actigraphy monitoring and a further subset (n = 40) additionally completed a laboratory-based assessment of dim-light melatonin onset (DLMO) as a circadian phase marker. A total of 659 participants with valid responses were finally included in the analyses of the data collected from part one of the study (female = 67.7%; mean age: 20.7 ± 2.02). Results showed that MCTQ parameters, namely the midpoint of sleep on free days (MSF), midpoint of sleep on workdays (MSW), and midpoint of sleep adjusted for sleep debt (MSFsc), were significantly correlated with MEQ score (r = -.514 to -.650, p < .01). Test-retest reliability for MCTQHK was good (intraclass correlation = 0.75 to 0.84). Later MSFsc was significantly associated with greater insomnia and depressive symptoms after controlling for age and sex. All MCTQ parameters showed significant correlations with actigraphy-based midpoint of sleep and circadian rhythm parameters, i.e., acrophase and L5 onset (r = .362 to .619, p < .01), as well as DLMO (r = .393 to .517, p < .05). The associations remained significant after controlling for age. MSFsc derived from MCTQ was significantly correlated with MEQ score in both the healthy sleepers and participants with insomnia (as defined by ISI > 14), r = -.600, p < .001 and r = -.543, p < .001, respectively. The present study demonstrated that MCTQHK is suitable for assessing chronotype with good reliability and validity in Chinese youths and supported the utility of MCTQHK in individuals with insomnia.
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Affiliation(s)
- Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Amy Wing Yin Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joey Wing Yan Chan
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ngan Yin Chan
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Jihui Zhang
- Guang Dong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chung Shun Ho
- Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Li Chiu Kong Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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87
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Sleep disorders and non-sleep circadian disorders predict depression: a systematic review and meta-analysis of longitudinal studies. Neurosci Biobehav Rev 2022; 134:104532. [PMID: 35041878 DOI: 10.1016/j.neubiorev.2022.104532] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/09/2022] [Accepted: 01/12/2022] [Indexed: 01/08/2023]
Abstract
Patients with depression often suffer from sleep disorders and non-sleep circadian disorders. However, whether they precede and predict subsequent depression is unclear. We conducted a meta-analysis of studies on sleep disorders and non-sleep circadian disorders. We found insomnia, hypersomnia, short and long sleep duration, obstructive sleep apnea, restless legs syndrome and eveningness orientation at baseline all led to subsequent depression. Those with propensity to late meal patterns, heightened levels of cortisol in awakening response and low robustness of rest-activity rhythm at baseline had higher risks for later depression. Among insomnia subtypes, difficulty initiating sleep and difficulty maintaining sleep predicted future depression. Notably, persistent insomnia at baseline contributed to more than two-fold risk of incident depression compared to insomnia. Moreover, insomnia symptom numbers showed dose-dependent relationship with the incident depression. In conclusion, different types of sleep disorders and non-sleep circadian disorders were proven to be risk factors of subsequent depression, and mechanisms underlying the relationship between sleep disorders, non-sleep circadian disorders and subsequent depression should be further elucidated in the future.
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88
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Wang J, Liu S, Guo J, Xiao R, Yu J, Luo X, Xu Y, Zhao Y, Cui Y, Gu Y, Cai L, Zhang B. Chronotypes, Sleep and Mental Distress Among Chinese College Students: A Cross-Sectional Study. Front Psychiatry 2022; 13:883484. [PMID: 35693958 PMCID: PMC9177998 DOI: 10.3389/fpsyt.2022.883484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/05/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the chronotypes and their relationship with sleep disturbances and mental distress among college students. METHODS Students from a university in Guangzhou, China, were recruited through a cross-sectional online survey. Data were collected by self-reported questionnaires including socio-demographics, lifestyles and health conditions, sleep patterns on weekdays and weekends, as well as the reduced Morningness-Eveningness Questionnaire (rMEQ), the Insomnia Severity Index, the Epworth Sleepiness Scale, the Beck Depression Inventory-13, and the Zung Self-Rating Anxiety Scale. Multivariate analyses were performed to examine the associations of chronotypes with sleep compensation, sleep disturbances, and mental distress. RESULTS A total of 1,607 questionnaires were received, among which 1,569 (97.6%) were valid for further analysis. Among these participants [mean age 19.86 ± 1.16 (15-27) years], morning types (M-types), intermediate types (I-types), and evening types (E-types) accounted for 14.9, 71.5, and 13.6%, respectively. The regression analysis revealed that E-types were positively associated with long sleep compensation on weekends (adjusted OR 2.443, 95%CI 1.740-3.429) compared with I-types, while M-types were the opposite (adjusted OR 0.623, 95%CI 0.392-0.990). E-types were also positively correlated with insomnia symptoms (adjusted OR 2.000, 95%CI 1.428-2.801), depressive symptoms (adjusted OR 2.068, 95%CI 1.496-2.858), and anxiety symptoms (adjusted OR 2.188, 95%CI 1.387-3.451). However, no significant association was found between chronotypes and excessive daytime sleepiness. CONCLUSION Our study found that E-types were associated with long sleep compensation on weekends and insomnia, depression, and anxiety symptoms. Our findings emphasized the importance of early recognition and intervention of E-types and their accompanied sleep problems and mental distress.
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Affiliation(s)
- Jiajia Wang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuai Liu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junlong Guo
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rong Xiao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jia Yu
- Department of Psychosomatic Diseases, The Third People's Hospital of Panzhihua, Panzhihua, China
| | - Xian Luo
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Xu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuhan Zhao
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yingru Cui
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yue Gu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lidan Cai
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Ricketts EJ, Burgess HJ, Montalbano GE, Coles ME, McGuire JF, Thamrin H, McMakin DL, McCracken JT, Carskadon MA, Piacentini J, Colwell CS. Morning light therapy in adults with Tourette's disorder. J Neurol 2022; 269:399-410. [PMID: 34120225 PMCID: PMC8666462 DOI: 10.1007/s00415-021-10645-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sleep disturbance is common among individuals with Tourette's Disorder (TD). Given that sleep is influenced by the circadian system, this study examined circadian rhythms and sleep in adults with TD, and explored the possible benefit of short-wavelength wearable morning light therapy. METHODS Participants were 34 adults with TD (n = 14) and age- and sex-matched healthy controls (HC; n = 20). Participants were screened using clinician-rated diagnostic and tic severity interviews, and procedures lasted 3 consecutive weeks. Participants completed a baseline week of actigraphy. Adults with TD completed 2 weeks of Re-Timer™ morning light therapy and continued actigraphy monitoring. Dim light melatonin-onset (DLMO) phase assessment, tic severity interview, and measures of chronotype, sleep disturbance, daytime sleepiness, disability, depression, anxiety, and stress were completed at baseline and post-intervention. RESULTS Adults with TD reported significantly greater eveningness and sleep disturbance relative to controls. Per wrist actigraphy, adults with TD exhibited significantly longer sleep-onset latency, lower sleep efficiency, and greater sleep fragmentation than HC. Following morning light therapy, there was a significant advance in DLMO phase, but not self-report or actigraphy sleep variables. There were small, statistically significant decreases in tic severity and impairment. There were also significant reductions in daytime sleepiness, and self-reported anxiety, but not depression, stress, or disability. Participants reported minimal side effects and rated light therapy as acceptable and comfortable. CONCLUSIONS Findings showed some benefits following brief light therapy in TD; further exploration of the impact of spectral tuning the photic environment as part of treatment for TD subjects is warranted.
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Affiliation(s)
- Emily J. Ricketts
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States
| | - Helen J. Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States
| | - Gabrielle E. Montalbano
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States
| | - Meredith E. Coles
- Department of Psychology, State University of New York at Binghamton, Binghamton, New York, United States
| | - Joseph F. McGuire
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Hardian Thamrin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States,Department of Psychology, Arizona State University, Tempe Arizona, United States
| | - Dana L. McMakin
- Department of Psychology, Florida International University, Miami, Florida, United States,Department of Neurology, Nicklaus Children’s Hospital, Miami, Florida, United States
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States
| | - Mary A. Carskadon
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, United States
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States
| | - Christopher S. Colwell
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, United States
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Felician J, Galvao F, Lefebvre M, Nourredine M, Peter-Derex L. Association of Delayed Sleep/Wake Rhythm with Depression During the First COVID-19 Lockdown in France. Nat Sci Sleep 2022; 14:1545-1557. [PMID: 36081862 PMCID: PMC9447448 DOI: 10.2147/nss.s369859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The containment of the population during the COVID-19 pandemic led to the emergence or recurrence of psychiatric conditions and sleep disorders. The influence of sleep/wake rhythm on mental health is well known. The objective of our study was to evaluate the link between the shift in sleep/wake rhythm and the presence of depressive symptoms during the March to May 2020 lockdown in the French population. PARTICIPANTS AND METHODS Participants (n = 2513) were recruited via newspapers and social networks in March 2020. We evaluated i) the chronotype before and during the lockdown, assessed by the change in mid-sleep time on work-free days corrected for sleep debt on workdays (delta MSFsc); ii) morningness-eveningness circadian preference (Horne & Ostberg questionnaire); iii) depressive symptoms (Patient Health Questionnaire-9, PHQ-9). The delta MSFsc and the PHQ-9 score were compared between circadian preference types. A multivariate model adjusted for age, sex, circadian preference, housing type, and marital status was used to assess the influence of delta MSFsc on the PHQ-9 score in the whole population. RESULTS The population consisted of 77% women, of median (IQR) age 39 (30-48) years. Compared with the pre-lockdown period, the median (IQR) MSFsc was shifted by 30 (0-66) min during the lockdown, with a significant difference between evening [60 (15-120) min], morning [15 (0-46) min] and neutral [30 (0-70) min] circadian type individuals, p < 0.001. One-third of all participants had moderate to severe depressive symptoms (PHQ-9 ≥ 10). A 1-hour shift in MSFsc was associated with a 0.50-point increase [95% CI (0.28; 0.72), p < 0.001] in the PHQ-9. CONCLUSION A phase delay in the chronotype was observed in the general population during lockdown. Such disruption was associated with depressive symptoms but the direction of the relationship remains hypothetical. The impact on mental health of preventive measures targeting the sleep/wake rhythm in this context needs further evaluation.
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Affiliation(s)
- Juliette Felician
- Centre for Sleep Medicine and Respiratory Diseases, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Medicine faculty, Lyon 1 University, Lyon, France.,Unité Michel Jouvet - Pôle Est - Z19, Centre Hospitalier Le Vinatier, Bron, France
| | - Filipe Galvao
- Unité Michel Jouvet - Pôle Est - Z19, Centre Hospitalier Le Vinatier, Bron, France
| | - Mylène Lefebvre
- Unité Michel Jouvet - Pôle Est - Z19, Centre Hospitalier Le Vinatier, Bron, France
| | - Mikail Nourredine
- Medicine faculty, Lyon 1 University, Lyon, France.,Biostatistics Unit, University Hospital Service of Pharmacotoxicology and Public Health Department, Hospices Civils de Lyon, Lyon, France.,Research Department, Centre Hospitalier Le Vinatier, Bron, France.,Biometry and Evolutionary Biology Laboratory, UMR CNRS 5558, Lyon, France
| | - Laure Peter-Derex
- Centre for Sleep Medicine and Respiratory Diseases, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Medicine faculty, Lyon 1 University, Lyon, France.,Lyon Neuroscience Research Centre, CNRS UMR 5292/INSERM U1028, Lyon, France
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91
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Supit A, Gosal M, Mamuaja P, Kumaat S, Paturusi A. Later Chronotype Correlates With Severe Depression in Indonesian College Students. SLEEP MEDICINE RESEARCH 2021. [DOI: 10.17241/smr.2021.00969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background and Objective The correlation between late chronotype and depression has been well documented, but reports from the equatorial area, where the sun shines throughout the year with less seasonal variation, are limited. In the present research study, we sought to 1) examine the relationship between the chronotype and mental health symptoms in an Indonesian student population and 2) explore the characteristics of those who lie at the extreme chronotype and psychometry.Methods This is a cross-sectional questionnaire-based study including undergraduate students in an Indonesian university (n = 493). We used the Munich Chronotype Questionnaires and the Depression, Anxiety, and Stress Scale to assess the chronotype and mental symptoms, respectively. Following this, a follow-up with an in-depth interview on the selected population at the extreme end of the chronotype was performed as an exploratory approach to identify their common characteristics.Results Among the tested parameters, the depression score was significantly associated with chronotype (p = 0.003), replicating previous findings from other areas with higher latitudes. The correlation persisted when males and females were analyzed separately (p = 0.008 and 0.037, respectively). A follow-up qualitative analysis revealed a potential subclinical, unrealized depression among the subjects; our findings revealed the use of smartphones during or before bedtime as a common factor among those with later chronotypes.Conclusions There is a correlation between depression score and chronotype among Indonesian college students, where subjects with later chronotype are more likely to have a higher depression score.
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92
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Norbury R. Night Owls and Lone Wolves. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2021.2014083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ray Norbury
- College of Health, Medicine and Life Sciences, Department of Life Sciences, Division of Psychology, Brunel University London, Uxbridge, UK
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93
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The Association between Temperament, Chronotype, Depressive Symptoms, and Disease Activity among Patients with Inflammatory Bowel Disease-A Cross-Sectional Pilot Study. Life (Basel) 2021; 11:life11121347. [PMID: 34947878 PMCID: PMC8706576 DOI: 10.3390/life11121347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/29/2021] [Accepted: 12/04/2021] [Indexed: 11/18/2022] Open
Abstract
The psychological aspect may play an important role in ulcerative colitis (UC) and Crohn’s disease (CD). The aims of this study were to explore the differences between patients with UC and CD regarding chronotype, temperament and depression, and to assess the psychological factors mentioned as predictors of disease activity. In total, n = 37 patients with UC and n = 47 patients with CD were included in the study. They underwent a clinical assessment, including the Mayo score or Crohn Disease Activity Index (CDAI), and completed questionnaires: a sociodemographic survey, Formal Characteristics of Behavior–Temperament Inventory (FCB-TI), Chronotype Questionnaire (CQ), and the Beck Depression Index II (BDI). The Sensory Sensitivity score was higher among patients with CD than UC (p = 0.04). The emotional reactivity and endurance scores were higher among women than men with CD (p = 0.028 and p = 0.012 respectively). CQ Morningness–Eveningness (ME) correlated with Endurance (p = 0.041), Emotional Reactivity (p = 0.016), and Activity (p = 0.004). ME correlated with Rhythmicity among CD patients (p = 0.002). The Mayo score was predicted by Perseverance. The CDAI score was predicted by the BDI score. The pattern of the relationship between chronotype and temperament may differentiate patients with UC and CD. Personal disposition may play a role in the clinical assessment of patients with IBD.
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94
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Silva S, Bicker J, Falcão A, Fortuna A. Antidepressants and Circadian Rhythm: Exploring Their Bidirectional Interaction for the Treatment of Depression. Pharmaceutics 2021; 13:1975. [PMID: 34834391 PMCID: PMC8624696 DOI: 10.3390/pharmaceutics13111975] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/13/2021] [Accepted: 11/16/2021] [Indexed: 01/07/2023] Open
Abstract
Scientific evidence that circadian rhythms affect pharmacokinetics and pharmacodynamics has highlighted the importance of drug dosing-time. Circadian oscillations alter drug absorption, distribution, metabolism, and excretion (ADME) as well as intracellular signaling systems, target molecules (e.g., receptors, transporters, and enzymes), and gene transcription. Although several antidepressant drugs are clinically available, less than 50% of depressed patients respond to first-line pharmacological treatments. Chronotherapeutic approaches to enhance the effectiveness of antidepressants are not completely known. Even so, experimental results found until this day suggest a positive influence of drug dosing-time on the efficacy of depression therapy. On the other hand, antidepressants have also demonstrated to modulate circadian rhythmicity and sleep-wake cycles. This review aims to evidence the potential of chronotherapy to improve the efficacy and/or safety of antidepressants. It includes pre-clinical and clinical studies that demonstrate the relevance of determining the most appropriate time of administration for antidepressant drugs. In parallel, their positive influence on the resynchronization of disrupted circadian rhythms is also herein discussed. It is expected that this review will promote the investigation of chronotherapy for the treatment of depression, contribute to a better understanding of the relationship between antidepressants and circadian rhythms, and consequently promote the development of new therapeutics.
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Affiliation(s)
- Soraia Silva
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal; (S.S.); (A.F.); (A.F.)
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
| | - Joana Bicker
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal; (S.S.); (A.F.); (A.F.)
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
| | - Amílcar Falcão
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal; (S.S.); (A.F.); (A.F.)
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
| | - Ana Fortuna
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal; (S.S.); (A.F.); (A.F.)
- CIBIT—Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
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95
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Mokros Ł, Witusik A, Szydłowska D, Jankowski KS, Kuna P, Pietras T. Mental health indices may fully mediate the relationship between morningness-eveningness and disease control among adult asthma patients. J Asthma 2021; 59:1923-1932. [PMID: 34606405 DOI: 10.1080/02770903.2021.1989463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: The aim of this study was to assess the association between morningness-eveningness and disease control with consideration of mental state as a mediator and the control of confounding factors among adult asthma patients.Methods: This is a cross-sectional study, which included a nonrandom sample of N = 66 patients from an outpatient unit with a confirmed asthma diagnosis, who gave an informed consent and completed a set of questionnaires: a survey comprising questions about sociodemographic and clinical characteristics, the Asthma Control Test (ACT), the Composite Scale of Morningness (CSM), and the General Health Questionnaire (GHQ-28). Mediation models were created separately for each GHQ-28 dimension (somatic symptoms, anxiety/insomnia, social dysfunction and depressive symptoms), for a total score and for four GHQ-28 dimensions together, considered as mediators.Results: Low morning affect was related to poor disease symptom control among patients with asthma. The effect was fully mediated by non-psychotic mental health indices. Evening-time preference was associated with a rise in asthma control, and mediated by somatic symptoms and anxiety/insomnia, when controlled for morning affect.Conclusions: The current study underlines the significance of assessment of both individual morningness-eveningness preference and mental health in the management of asthma symptoms.
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Affiliation(s)
- Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Andrzej Witusik
- Faculty of Composition, Theory of Music, Conducting, Eurhythmics and Music Education, Music Therapy Course, Grazyna and Kiejstut Bacewicz Memorial Academy of Music in Lodz, Lodz, Poland
| | - Dorota Szydłowska
- Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | | | - Piotr Kuna
- Clinical Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland
| | - Tadeusz Pietras
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
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96
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Naftalovich H, Anholt GE, Keren R, Ben Arush O, Kalanthroff E. Waxing and waning: The roles of chronotype and time of day in predicting symptom fluctuations in obsessive-compulsive disorder using a daily-monitoring design. J Psychiatr Res 2021; 143:91-97. [PMID: 34461354 DOI: 10.1016/j.jpsychires.2021.08.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/23/2021] [Accepted: 08/19/2021] [Indexed: 02/01/2023]
Abstract
Obsessive-compulsive disorder (OCD) symptoms fluctuate throughout the day, but scientists are not sure what underlies these fluctuations. One factor which may explain how OCD symptoms wax and wane throughout the day is alertness. Increased alertness is associated with greater inhibitory control, a factor which plays a significant role in patients' ability to overcome their OCD symptoms. The current study examined the relationship between chronotype (morningness/eveningness preference, a measure of alertness) and within-day OCD symptom severity fluctuations. We hypothesized that increased alertness leads to better inhibitory abilities and, therefore, reduced OCD symptoms. OCD Symptoms were measured through 7-days of monitoring in which participants were asked to retrospectively rate their symptoms at several timepoints throughout the day. Chronotype was measured using the Morningness/Eveningness Questionnaire (MEQ). Consistent with our hypotheses, results revealed an interaction between chronotype and time of day, such that those with an eveningness preference tended to have worse symptoms in the morning, and vice versa. In addition, we also report novel findings regarding the effect of bedtime, sleep duration, and sleep quality on symptom severity the next day. Taken together, these findings suggest that alertness may modulate OCD symptom severity throughout the day such that individuals experience more severe symptoms during times of low alertness. The clinical and theoretical implications of these findings are discussed.
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Affiliation(s)
- Hadar Naftalovich
- Department of Psychology, The Hebrew University of Jerusalem, Israel.
| | - Gideon E Anholt
- Department of Psychology, Ben-Gurion University of the Negev, Israel
| | - Rotem Keren
- Functional Neurosurgery Department, Tel-Aviv Sourasky Medical Center, Israel
| | - Oded Ben Arush
- The Obsessive and Compulsive Related Disorders Center, Modi'in, Israel
| | - Eyal Kalanthroff
- Department of Psychology, The Hebrew University of Jerusalem, Israel
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97
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Zareba MR, Fafrowicz M, Marek T, Beldzik E, Oginska H, Domagalik A. Late chronotype is linked to greater cortical thickness in the left fusiform and entorhinal gyri. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2021.1990501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Michal Rafal Zareba
- Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University, Kraków, Poland
- Brain Imaging Core Facility, Malopolska Centre of Biotechnology, Jagiellonian University, Kraków, Poland
| | - Magdalena Fafrowicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Tadeusz Marek
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Ewa Beldzik
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Halszka Oginska
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Aleksandra Domagalik
- Brain Imaging Core Facility, Malopolska Centre of Biotechnology, Jagiellonian University, Kraków, Poland
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98
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Arrona-Palacios A, Díaz-Morales JF, Parra-Robledo Z, Adan A. Sleep and Depressive Symptoms in the Morningness/Eveningness-Suicidal Ideation Relationship Depend on School Shift in Mexican Adolescents. J Clin Med 2021; 10:jcm10204681. [PMID: 34682804 PMCID: PMC8540773 DOI: 10.3390/jcm10204681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022] Open
Abstract
The aim was to analyze the morningness/eveningness (M/E) effect on suicidal ideation through sleep and depressive symptoms mediators with school shift (i.e., morning and afternoon) as moderator. In this study, 586 Mexican adolescents, with a mean age of 16.31 ± 0.92, from a public high school in a double-shift school system (298 from the morning shift and 288 from the afternoon shift) participated. Measurements of sleep, morningness/eveningness (circadian preference), depressive symptomology, and suicidal ideation were completed. Adolescents in the afternoon shift reported a later rise time, bedtime, greater time in bed sleep length, and less social jet lag than in the morning shift. Considering the moderated-mediated analysis, circadian preference and suicidal ideation were mediated by both depressive symptoms and school day’s sleep length in the morning shift. In the afternoon shift, no mediation effect was significant. When weekend sleep length was considered in the model, only depressive symptoms had a mediating effect between circadian preference and suicidal ideation in the morning shift; no significant mediating effect was found on the afternoon shift. The results suggest that an afternoon school schedule may act as a protective factor for the adolescent’s mental health and may represent a viable option for future interventions.
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Affiliation(s)
- Arturo Arrona-Palacios
- Writing Lab, Institute for the Future of Education, Tecnológico de Monterrey, Monterrey 64849, Mexico;
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Juan F. Díaz-Morales
- Department of Social Psychology, Work and Individual Differences, Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.F.D.-M.); (Z.P.-R.)
| | - Zaida Parra-Robledo
- Department of Social Psychology, Work and Individual Differences, Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.F.D.-M.); (Z.P.-R.)
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
- Correspondence:
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Merikanto I, Partonen T. Eveningness increases risks for depressive and anxiety symptoms and hospital treatments mediated by insufficient sleep in a population-based study of 18,039 adults. Depress Anxiety 2021; 38:1066-1077. [PMID: 34170060 DOI: 10.1002/da.23189] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/22/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Epidemiological data show that having the eveningness associates with poor mental health. For preventive measures it is important to know which underlying factors mediate these associations and the burden posed to public health. This study examines at a population-based level, whether (1) circadian type and the sleep-wake behavior-based phase entrainment similarly associate with mental health problems, (2) there are differences in hospital treatments due to mental disorders between chronotypes, and (3) the association of chronotype with mental health is mediated by insufficient sleep. METHODS The study sample (N = 18,039) consisted of population-based sample of Finnish adults, aged 25-74 years, with information on their circadian type and sleep patterns, mental health symptoms, and diagnosis as reported in a health examination survey, as well as hospital treatments as recorded on the national Hospital Discharge Register. RESULTS All the mental health symptoms, diagnoses and hospital treatments were more pronounced among Evening-types, especially when assessed by circadian type. Insufficient sleep mediated most but not all of the associations between eveningness and mental health. CONCLUSIONS Eveningness does not increase mental health risks only on symptom or diagnosis level, but also on hospital admission level. A higher prevalence of insufficient sleep among the Evening-types elevates the risk and severity for many of the mental health outcomes. Improving the sleep among Evening-types could help to improve their mental health prospective and ease the health care burden.
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Affiliation(s)
- Ilona Merikanto
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland.,SleepWell Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Orton Orthopaedics Hospital, Helsinki, Finland
| | - Timo Partonen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
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Weekend catch-up sleep and depression: results from a nationally representative sample in Korea. Sleep Med 2021; 87:62-68. [PMID: 34520972 DOI: 10.1016/j.sleep.2021.02.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is limited information on the association between weekend catch-up sleep (CUS), which has beneficial effects on health, and depression. This study aimed to investigate the association between CUS and depression in adults. METHODS We used the data of the Seventh Korea National Health and Nutrition Examination Survey, 2016. Depression was defined as Patient Health Questionnaire-9 score ≥10. We categorized CUS duration as ≤0, 0 < to 1, 1 < to 2, and >2 h. RESULTS Of 5550 eligible participants, 3286 (54.9%), 1033 (19.5%), 723 (14.7%) and 508 (10.9%) had CUS duration ≤0, 0 < to 1, 1 < to 2, and >2 h, respectively; of these, the prevalence of depression was 7.0%, 4.2%, 2.9%, and 6.0%, respectively. Multivariable regression analyses including covariates revealed that individuals with CUS duration 1 < to 2 h had a significantly decreased risk of depression compared to individuals with CUS duration ≤0 h (odds ratio [OR] = 0.517, 95% CI = 0.309-0.865). Individuals with CUS duration 0 < to 1 h (OR = 0.731, 95% CI = 0.505-1.060) and >2 h (OR = 1.164, 95% CI = 0.718-1.886) showed no significantly different risk of depression. CONCLUSIONS The risk of depression in individuals with CUS duration 1 < to 2 h was lower than for those with CUS duration ≤0 h. This finding provides a better understanding on the association between CUS and depression; and can be a basis for better management of depression.
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