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Cheung FTW, Li X, Hui TK, Chan NY, Chan JW, Wing YK, Li SX. Circadian preference and mental health outcomes in youth: A systematic review and meta-analysis. Sleep Med Rev 2023; 72:101851. [PMID: 37793219 DOI: 10.1016/j.smrv.2023.101851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 07/10/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
Youth is a vulnerable developmental period associated with an increased preference for eveningness and risk for developing psychopathology. Growing evidence suggests a link between eveningness and poorer mental health outcomes, but the findings in the current literature are inconsistent, and a comprehensive synthesis of evidence in this area remains lacking. This meta-analysis aimed to 1) synthesise the existing evidence on the association between circadian preference and mental health outcomes in youths and 2) explore potential sleep-related factors that may moderate the relationship between circadian preference and mental health outcomes. A systematic search of five electronic databases resulted in 81 observational studies included in the review. Eveningness was found to be significantly associated with general mental health (r = 0.20), mood-related disturbances (r = 0.17), and anxiety problems (r = 0.13). The qualitative review also identified that eveningness was associated with greater risks for psychotic symptoms and maladaptive eating behaviours. These findings highlighted the need to consider circadian preference in the clinical management of youth mental health problems. Further research is needed to examine the efficacy of a circadian-focused intervention in the context of youth mental health.
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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.
| | - Xiao Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Tsz Kwan Hui
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Joey Wy Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Yun Kwok Wing
- Li Chiu Kong Family 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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2
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Cruz-Sanabria F, Violi M, Bazzani A, Bruno S, Massoni L, Bertelloni CA, Dell'Oste V, Frumento P, Faraguna U, Dell'Osso L, Carmassi C. Chronotype is differentially associated with lifetime mood and panic-agoraphobic spectrum symptoms in patients with bipolar disorder and healthy controls. CNS Spectr 2023; 28:726-738. [PMID: 36942635 DOI: 10.1017/s1092852923001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE Although the association between chronotype and mood disorders has been consistently reported, conversely, attempts to measure the association between chronotype and anxiety symptoms have generated inconsistent results. We aimed at evaluating whether chronotype (assessed through subjective and objective measures) is associated with lifetime mood and panic-agoraphobic spectrum symptoms in healthy controls (HCs) and in patients with bipolar disorder (BD). METHODS Overall, 173 subjects, patients with BD in euthymic phase (n = 76) and HC (n = 97), were evaluated through the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy monitoring and mood and panic-agoraphobic spectrum self-report (MOODS-SR and PAS-SR). The discrepancy between objective (actigraphic-based) versus subjective (rMEQ-based) circadian typology was estimated through the Circadian Classification Discrepancy Index (CCDI). RESULTS rMEQ-based evening chronotype (ET) was associated with higher scores in MOODS-SR depressive and rhythmicity and vegetative functions domains in HC and BD.Both ET and morning chronotypes (MT) were associated with higher PAS-SR scores in BD only. Actigraphic-based MT was associated with higher MOODS-SR depressive scores in HC. Likewise, the discrepancy between actigraphic-based and rMEQ-based circadian typology was associated with depressive symptoms in HC only. CONCLUSION Self-reported ET was consistently associated with mood symptoms, while associations with panic-agoraphobic symptoms only emerged in BD and involved both extreme chronotypes. The discrepancy between the preferred circadian typology (rMEQ-based) and the actual one (actigraphic-based) could contribute to depressive symptoms in HC. These results pave the way for interventional studies targeting circadian typology in an attempt to prevent or treat mental health disorders.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Valerio Dell'Oste
- Department of Biotechnology Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Calambrone, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Conway A, Miller AL. Social jetlag longitudinally predicts internalizing and externalizing behavior for adolescent females, but not males. Chronobiol Int 2023; 40:1404-1418. [PMID: 37814409 DOI: 10.1080/07420528.2023.2265480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
Biological changes contribute to preferences for later bed and wake times during adolescence, yet the social constraints of school start times necessitate early wake times. This often results in social jetlag (i.e. misalignment between preferred sleep timing on weekends and school days). We examined whether social jetlag predicts adolescent internalizing and externalizing behavior over time and/or whether associations differ based on sex. We used data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development Study (n = 767) to test whether social jetlag at 6th grade (ages 12-13 years) predicted internalizing and externalizing behavior at age 15 years and whether child sex moderated associations. Controlling for internalizing and externalizing behavior at 6th grade (ages 12-13 years), results were that social jetlag at 6th grade (ages 12-13 years) predicted more internalizing and externalizing behaviors at age 15 for females, but not males. These findings show that social jetlag during early adolescence confers risk for internalizing and externalizing behavior in females at mid-adolescence. Greater attention should be placed on identifying and addressing social jetlag in adolescent females.
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Affiliation(s)
- Anne Conway
- Social Work, University of Tennessee, Knoxville, Knoxville, Tennessee, USA
- Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Alison L Miller
- Public Health, University of Michigan, Ann Abor, Michigan, USA
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Chauhan S, Norbury R, Faßbender KC, Ettinger U, Kumari V. Beyond sleep: A multidimensional model of chronotype. Neurosci Biobehav Rev 2023; 148:105114. [PMID: 36868368 DOI: 10.1016/j.neubiorev.2023.105114] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023]
Abstract
Chronotype can be defined as an expression or proxy for circadian rhythms of varied mechanisms, for example in body temperature, cortisol secretion, cognitive functions, eating and sleeping patterns. It is influenced by a range of internal (e.g., genetics) and external factors (e.g., light exposure), and has implications for health and well-being. Here, we present a critical review and synthesis of existing models of chronotype. Our observations reveal that most existing models and, as a consequence, associated measures of chronotype have focused solely or primarily on the sleep dimension, and typically have not incorporated social and environmental influences on chronotype. We propose a multidimensional model of chronotype, integrating individual (biological and psychological), environmental and social factors that appear to interact to determine an individual's true chronotype with potential feedback loops between these factors. This model could be beneficial not only from a basic science perspective but also in the context of understanding health and clinical implications of certain chronotypes as well as designing preventive and therapeutic approaches for related illnesses.
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Affiliation(s)
- Satyam Chauhan
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom.
| | - Ray Norbury
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom
| | | | | | - Veena Kumari
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom.
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5
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Fernando J, Stochl J, Ersche KD. Drug Use in Night Owls May Increase the Risk for Mental Health Problems. Front Neurosci 2022; 15:819566. [PMID: 35087376 PMCID: PMC8787192 DOI: 10.3389/fnins.2021.819566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Drugs of abuse are widely known to worsen mental health problems, but this relationship may not be a simple causational one. Whether or not a person is susceptible to the negative effects of drugs of abuse may not only be determined by their addictive properties, but also the users’ chronotype, which determines their daily activity patterns. The present study investigates the relationship between chronotype, drug use and mental health problems in a cross-sectional community sample. Participants (n = 209) completed a selection of questionnaires online, including the Munich Chronotype Questionnaire, the Depression Anxiety Stress Scale, the Alcohol Use Disorder Identification Test, the Cannabis Use Disorder Identification Test and the Fagerström Test for Nicotine Dependence. We conducted multiple regression models to determine relationships between participants’ chronotype and their reported mental health symptoms and then estimated mediation models to investigate the extent to which their drug consumption accounted for the identified associations. Chronotype was significantly associated with participants’ overall mental health (β = 0.16, p = 0.022) and their anxiety levels (β = 0.18, p = 0.009) but not with levels of depression or stress. However, both relationships were fully mediated by participants’ overall drug consumption. Thus, late chronotypes, so-called “night owls”, not only use more drugs but consequently have an increased risk for developing anxiety and deteriorating mental health status. This group may be particularly vulnerable to the negative psychological effects of drugs. Our results point toward the importance of considering chronotype in designing preventative and therapeutic innovations, specifically for anxiety, which at present has been largely neglected.
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Affiliation(s)
- Jeevan Fernando
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Kinanthropology and Humanities, Charles University, Prague, Czechia
| | - Karen D. Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Karen D. Ersche,
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Caliandro R, Streng AA, van Kerkhof LWM, van der Horst GTJ, Chaves I. Social Jetlag and Related Risks for Human Health: A Timely Review. Nutrients 2021; 13:nu13124543. [PMID: 34960096 PMCID: PMC8707256 DOI: 10.3390/nu13124543] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/11/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022] Open
Abstract
The term social jetlag is used to describe the discrepancy between biological time, determined by our internal body clock, and social times, mainly dictated by social obligations such as school or work. In industrialized countries, two-thirds of the studying/working population experiences social jetlag, often for several years. Described for the first time in 2006, a considerable effort has been put into understanding the effects of social jetlag on human physiopathology, yet our understanding of this phenomenon is still very limited. Due to its high prevalence, social jetlag is becoming a primary concern for public health. This review summarizes current knowledge regarding social jetlag, social jetlag associated behavior (e.g., unhealthy eating patterns) and related risks for human health.
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Affiliation(s)
- Rocco Caliandro
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
| | - Astrid A. Streng
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands;
| | - Linda W. M. van Kerkhof
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands;
| | - Gijsbertus T. J. van der Horst
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
| | - Inês Chaves
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands; (R.C.); (A.A.S.); (G.T.J.v.d.H.)
- Correspondence: ; Tel.: +31-10-704-3456; Fax: +31-10-704-4743
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Srinivasan V, Vishnuram S, Suganthirababu P, Kumaresan A, Divyalaxmi P, Saranya Devi M, Alagesan J. Impact of COVID-19 online classes on morningness-eveningness personality among adult college students: A survey study. Work 2021; 70:695-700. [PMID: 34719463 DOI: 10.3233/wor-210528] [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: 11/15/2022] Open
Abstract
BACKGROUND COVID-19 emerged as a serious pandemic in 2019 and billions of people were infected. Various precautionary methods were taken to contain the spread of virus such as social distancing, public lockdown, sanitation, and closure of schools and colleges. Many colleges started online classes to resume their syllabus and to complete the course curriculum. These evening online sessions resulted in late night sleep, long term mobile/computer exposure, and disturbed sleep pattern. OBJECTIVE The present study aimed to determine the impact of COVID-19 online classes on morningness- eveningness personality and to compare it with different age groups, gender, and body mass index. METHODS The cluster sampling method was used to collect the subjects from the total of 1153 adult college students, 897 subjects were selected based on the selection criteria and instructed to submit an online survey consists of the Morningness-eveningness Questionnaire and demographic and anthropometric data through mail, social media, or through a researcher by direct interview. RESULTS The mean score for the 897 participants is 56.7, indicating intermediate morningness-eveningness personality type. On comparing the different groups, the youngest group (18-20 years) scored 4.23%(mean = 46.7), female subjects scored 6.13%(mean = 58.1), the underweight 2.67%(mean = 59.2) and overweight groups scored 2.89%(mean = 59.7) indicating definite eveningness. Among the 897 collected samples of the population 8.13%of the subjects experienced definite eveningness, 14.93%has moderate eveningness, 17.38%are under intermediate category, 22.4%have moderate morningness, and 37.11%have definite morningness. CONCLUSIONS Subjects with eveningness personality have high risk of developing mental illness, thus it's important to determine the eveningness personality among student population to avoid serious complications in later age.
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Affiliation(s)
| | | | | | - A Kumaresan
- Saveetha College of Physiotherapy, SIMATS, Chennai, India
| | - P Divyalaxmi
- Saveetha College of Physiotherapy, SIMATS, Chennai, India
| | - M Saranya Devi
- Saveetha College of Physiotherapy, SIMATS, Chennai, India
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8
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Shier AJ, Keogh T, Costello AM, Riordan AO, Gallagher S. Eveningness, depression and cardiovascular reactivity to acute psychological stress: A mediation model. Physiol Behav 2021; 240:113550. [PMID: 34371021 DOI: 10.1016/j.physbeh.2021.113550] [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] [Received: 05/27/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022]
Abstract
The psychological pathways linking depression to blunted cardiovascular reactivity (CVR) are still being elucidated. The purpose of the present study was to test whether the association between eveningness, a diurnal/sleep-wake preference and CVR would be mediated by depressive symptoms. One hundred and eighty-two healthy young adults completed measures of morningness/eveningness (the Morningness-Eveningness Questionnaire; MEQ-SA), depressive symptoms (Hospital Anxiety and Depression Scale; HADS) and had their blood pressure and heart rate monitored throughout a standardised stress testing protocol. Results indicated that depressive symptoms were negatively associated with systolic blood pressure (SBP) but not diastolic blood pressure (DBP) or heart rate (HR) reactions to the stress task. Eveningness was also negatively associated with both SBP and DBP, but not HR. As such, those who reported increased depressive symptomology, and higher scores on eveningness displayed a more blunted cardiovascular response. Furthermore, the latter relationship was mediated by depressive symptoms such that those reporting higher scores on eveningness also reported increased depressive symptomology and this resulted in blunted CVR for SBP. These findings withstood adjustment for several confounding factors including time of testing. In conclusion, the present findings highlight the importance of considering eveningness when looking at the depression-blunted CVR relationship.
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Affiliation(s)
- Adam J Shier
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.
| | - Tracey Keogh
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Aisling M Costello
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Adam O' Riordan
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
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9
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Silva ACPE, Dos Santos MJ, Góes Gitaí DL, de Miranda Coelho JAP, de Andrade TG. Depression and anxiety symptoms correlate with diurnal preference, sleep habits, and Per3 VNTR polymorphism (rs57875989) in a non-clinical sample. J Affect Disord 2020; 277:260-270. [PMID: 32841827 DOI: 10.1016/j.jad.2020.07.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/29/2020] [Accepted: 07/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Evidences suggest that alterations in circadian rhythms trigger the development of mental disorders. Eveningness, sleep behavior, and circadian genes polymorphisms have been associated with depression and anxiety symptomatology. However, the mechanism underlying these interactions is not well understood. We investigated the contribution of diurnal preference, sleep habits, and PER3 VNTR polymorphism (rs57875989) to depression and anxiety symptoms in a Northeast sample from the Brazilian population. METHODS Eight hundred and four young adults completed the Morningness-Eveningness (MEQ), Munich Chronotype (MCTQ), Center for Epidemiologic Studies - Depression (CES-D), and Beck Anxiety Inventory (BAI) questionnaires. All participants were genotyped and linear regression was performed to test the interactions between the genetic /behavioral variants and depression/ anxiety symptoms. RESULTS Eveningness and sleep behaviors (bedtime, wake-up time, sleep duration, and midpoint of sleep) were correlated with depression symptomatology, specifically in somatic factors of the CES-D questionnaire. No correlation was found between diurnal preference/sleep habits with anxiety symptoms for both BAI total score and its factors. However, women with PER34/4 genotype showed less interpesonal affect in depression symptomatology and more anxiety symptoms in four factors of the BAI questionnaire. LIMITATIONS Mainly because this study was based on self-report questionnaires and was limited to undergraduate students aging 18 to 30 years old. CONCLUSION These results reinforce a role for sleep and diurnal preference in depression, and PER3 VNTR polymorphism in anxiety symptomatology, particularly in women.
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Affiliation(s)
| | | | | | | | - Tiago Gomes de Andrade
- Circadian Medicine Center, Faculty of Medicine, Federal University of Alagoas, Maceió, Brazil.
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10
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Shimizu M, Gillis BT, Buckhalt JA, El-Sheikh M. Linear and Nonlinear Associations between Sleep and Adjustment in Adolescence. Behav Sleep Med 2020; 18:690-704. [PMID: 31537121 PMCID: PMC7080596 DOI: 10.1080/15402002.2019.1665049] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND & OBJECTIVES A growing body of work supports linear associations between sleep and socioemotional adjustment in adolescence. However, associations between sleep and adjustment are not necessarily linear and investigations of nonlinear effects are scarce. This study examined linear and nonlinear relations between several sleep-wake parameters and externalizing behavior and internalizing symptoms in adolescence, and assessed the role of adolescent sex as a moderator of effects. PARTICIPANTS Participants were high school students (N = 180; M age = 17.49, SD = .62; 59% female; 68% White/European American, 32% Black/African American) from a wide range of socio-economic backgrounds living in semirural communities and small towns in Alabama. METHODS Sleep-wake parameters were indexed by actigraphy-derived sleep minutes and adolescents' reports on morningness-eveningness (circadian preference), sleep-wake problems (sleep quality), and sleepiness. Adolescents completed questionnaires on externalizing behaviors and internalizing symptoms. RESULTS Controlling for sleep duration, a higher preference for eveningness and poor sleep quality were associated in a linear fashion with increased externalizing and internalizing symptoms. Nonlinear relations between sleepiness and internalizing symptoms emerged with pronounced sex-related effects, including somewhat delayed accelerating relations for males and rapidly accelerating associations that tended to plateau for females. CONCLUSIONS Results illustrate the importance of examining multiple sleep-wake and adjustment variables as well as linear and nonlinear associations.
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Affiliation(s)
- Mina Shimizu
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Brian T. Gillis
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
| | - Joseph A. Buckhalt
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Alabama, Auburn
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama
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11
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Short MA, Booth SA, Omar O, Ostlundh L, Arora T. The relationship between sleep duration and mood in adolescents: A systematic review and meta-analysis. Sleep Med Rev 2020; 52:101311. [DOI: 10.1016/j.smrv.2020.101311] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/26/2022]
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12
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Bettencourt C, Tomé B, Pires L, Leitão JA, Gomes AA. Emotional states in adolescents: time of day X chronotype effects while controlling for psychopathological symptoms and sleep variables. BIOL RHYTHM RES 2020. [DOI: 10.1080/09291016.2020.1783489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Catarina Bettencourt
- Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
| | - Beatriz Tomé
- Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
| | - Luís Pires
- CINEICC - FCT R&D Unit: Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
- Memory, Language and Executive Functions Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - José Augusto Leitão
- Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
- CINEICC - FCT R&D Unit: Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
- Memory, Language and Executive Functions Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Ana Allen Gomes
- Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
- CINEICC - FCT R&D Unit: Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra (FPCE-UC), Coimbra, Portugal
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Gao Q, Sheng J, Qin S, Zhang L. Chronotypes and affective disorders: A clock for mood? BRAIN SCIENCE ADVANCES 2020. [DOI: 10.26599/bsa.2019.9050018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Affective disorders are often accompanied by circadian rhythm disruption and the major symptoms of mental illness occur in a rhythmic manner. Chronotype, also known as circadian preference for rest or activity, is believed to exert a substantial influence on mental health. Here, we review the connection between chronotypes and affective disorders, and discuss the potential underlying mechanisms between these two phenomena.
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Affiliation(s)
- Qian Gao
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology and the Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan 430074, Hubei, China
| | - Juan Sheng
- Jingzhou Mental Health Center, Jingzhou 434000, Hubei, China
| | - Song Qin
- Jingzhou Mental Health Center, Jingzhou 434000, Hubei, China
| | - Luoying Zhang
- Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology and the Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan 430074, Hubei, China
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14
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Rodrigues PFS, Pandeirada JNS, Bem-Haja P, Marinho PI, Fernandes NL, Ribeiro L, Silva CF. Assessing circadian preferences in Portuguese adolescents: development and preliminary validation of a reduced Morningness–Eveningness Questionnaire. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2018.1512291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Pedro F. S. Rodrigues
- CINTESIS.UA, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- IBILI, University of Coimbra, Coimbra, Portugal
| | | | - Pedro Bem-Haja
- CINTESIS.UA, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- IBILI, University of Coimbra, Coimbra, Portugal
| | | | | | - Lígia Ribeiro
- Division of Local Development, Municipality of Águeda, Águeda, Portugal
| | - Carlos F. Silva
- CINTESIS.UA, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
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15
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Wilson C, Carpenter J, Hickie I. The Role of the Sleep-Wake Cycle in Adolescent Mental Illness. CURRENT SLEEP MEDICINE REPORTS 2019. [DOI: 10.1007/s40675-019-00145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Henderson SEM, Brady EM, Robertson N. Associations between social jetlag and mental health in young people: A systematic review. Chronobiol Int 2019; 36:1316-1333. [DOI: 10.1080/07420528.2019.1636813] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sarah E. M. Henderson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Emer M. Brady
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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17
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Sun W, Ling J, Zhu X, Lee TMC, Li SX. Associations of weekday-to-weekend sleep differences with academic performance and health-related outcomes in school-age children and youths. Sleep Med Rev 2019; 46:27-53. [DOI: 10.1016/j.smrv.2019.04.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 03/22/2019] [Accepted: 04/02/2019] [Indexed: 12/26/2022]
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18
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Haraden DA, Mullin BC, Hankin BL. Internalizing symptoms and chronotype in youth: A longitudinal assessment of anxiety, depression and tripartite model. Psychiatry Res 2019; 272:797-805. [PMID: 30832201 PMCID: PMC6498437 DOI: 10.1016/j.psychres.2018.12.117] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/21/2018] [Accepted: 12/22/2018] [Indexed: 12/01/2022]
Abstract
Biological rhythm theories highlight the reciprocal relations between dysregulated circadian patterns and internalizing psychopathology. Chronotype characterizes individuals' diurnal preference, as some exhibit more morningness or eveningness. Previous research suggests that eveningness prospectively predicts depression in adolescence. Anxiety often co-occurs with depression, but little is known about longitudinal, reciprocal associations between chronotype and anxiety, and whether this relationship remains after controlling for depression. We assessed different forms of anxiety (social, panic, separation), positive/negative affect, anxious arousal (from tripartite theory), and depression, in relation to chronotype to better understand the specificity and directionality of associations between chronotype and internalizing problems in adolescence. Community youth participated in three assessment time points: T1, T2 (18-months post-T1), and T3 (30-months post-T1) as part of a larger longitudinal study. Youth completed self-report measures of anxiety, depression, positive and negative affect, and chronotype. Regression analyses showed that eveningness: (1) concurrently associated with decreased separation anxiety, elevated symptoms of depression and low levels of positive affect, (2) was prospectively predicted by elevated depression, (3) did not predict later symptoms of anxiety. The reciprocal, prospective relationship between chronotype and internalizing psychopathology is specific to depression during adolescence.
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Affiliation(s)
- Dustin A. Haraden
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Benjamin C. Mullin
- Department of Psychiatry, University of Colorado School of Medicine, Denver, CO, USA
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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19
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Gariépy G, Riehm KE, Whitehead RD, Doré I, Elgar FJ. Teenage night owls or early birds? Chronotype and the mental health of adolescents. J Sleep Res 2018; 28:e12723. [PMID: 29998523 DOI: 10.1111/jsr.12723] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/09/2018] [Accepted: 05/28/2018] [Indexed: 11/28/2022]
Abstract
Evidence suggests that the timing of sleep (chronotype) impacts mental health in young people, but previous studies have not accounted for sleep duration or school start time in this association, or examined a broad range of mental outcomes. In this study, we investigated the association between chronotype and mental health in a representative sample of adolescents from the 2014 Canadian Health Behaviour in School-Aged Children survey (29,635 students, 362 schools). We examined positive and negative aspects of mental health, using scores for emotional problems (range 0-33), emotional well-being (0-22), behavioural problems (0-28) and prosocial behaviours (0-25). We estimated chronotype using the time of mid-sleep on weekends and examined the associations using multilevel regressions, adjusted for sleep duration, school start time, individual, family and geographic characteristics. The average time of mid-sleep (chronotype) was 04:11 hr. An hour delay in mid-sleep time was associated with more emotional problems (0.34 [95% confidence interval 0.23, 0.45] point higher score), more behavioural problems (2.0% [95% confidence interval 1.4%, 2.6%] higher score), less emotional well-being (0.19 [95% confidence interval 0.09, 0.20] point lower score), and fewer prosocial behaviours (0.18 [95% confidence interval 0.08, 0.29] point lower score). A later chronotype was associated with poorer mental health, independent of sleep duration and school start time, and across internalizing and externalizing mental health domains. Further research is needed to clarify the mechanisms underlying this association. The timing of sleep, and not just its duration, may be an additional consideration for youth mental health.
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Affiliation(s)
- Geneviève Gariépy
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada
| | - Kira E Riehm
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Isabelle Doré
- Department of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.,Centre de Recherche de l'Université de Montréal, Montreal, QC, Canada
| | - Frank J Elgar
- Institute for Health and Social Policy, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
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20
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Abstract
PURPOSE OF REVIEW Chronotype, reflecting interindividual differences in daily activity patterns and sleep-wake cycles, is intrinsically connected with well-being. Research indicates increased risk of many adverse mental health outcomes for evening-type individuals. Here, we provide an overview of the current evidence available on the relationship between chronotype and psychiatric disorders. RECENT FINDINGS The association between eveningness and depression is well established cross-sectionally, with preliminary support from longitudinal studies. The mechanisms underlying this relationship warrant further research; deficient cognitive-emotional processes have recently been implicated. Eveningness is associated with unhealthy lifestyle habits, and the propensity of evening types to addiction has been recognized. Chronotype may also be implicated in disordered eating. SUMMARY Eveningness is associated with depression-including seasonal affective disorder (SAD)-and substance dependence, while support for a relation with anxiety disorders and psychosis is lacking. In bipolar disorder, chronotype is linked to depression but not mania. Eveningness is also related to sleep disturbances and poor lifestyle habits, which may increase risk for psychiatric disorders.
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Affiliation(s)
- Liia Kivelä
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Marinos Rodolfos Papadopoulos
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
| | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands
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21
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Simor P, Harsányi A, Csigó K, Miklós G, Lázár AS, Demeter G. Eveningness is associated with poor sleep quality and negative affect in obsessive-compulsive disorder. J Behav Addict 2018; 7:10-20. [PMID: 29415552 PMCID: PMC6035014 DOI: 10.1556/2006.7.2018.07] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/18/2018] [Accepted: 01/21/2018] [Indexed: 11/19/2022] Open
Abstract
Background Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors that severely encumber daily functioning. OCD patients seem to exhibit sleep disturbances, especially delayed bedtimes that reflect disrupted circadian rhythmicity. Morningness-eveningness is a fundamental factor reflecting individual variations in diurnal preferences related to sleep and waking activities. Eveningness reflecting a delayed sleep-wake timing has repeatedly been associated with sleep problems and negative affect (NA). Therefore, the aim of this study was to examine the associations between morningness-eveningness, sleep complaints, and symptom severity in OCD patients and compared with a mixed psychiatric control group. Materials and methods The data of 49 OCD and 49 mixed psychiatric inpatients (with unipolar depression and anxiety disorders) were analyzed. Patients completed questionnaires regarding morningness-eveningness, sleep quality, nightmare frequency, depression, anxiety, and affective states. Obsessive and compulsive symptom severity was also assessed within the OCD group by clinician-rated scales. Results Eveningness preference was associated with impaired sleep quality and higher NA in OCD patients. In addition, impaired sleep quality showed a moderate correlation with anxiety and strong correlations with depressive symptoms and NA. Interestingly, in the mixed psychiatric group, eveningness was not linked to NA, and sleep quality also showed weaker associations with depressive symptoms and NA. Within the OCD group, eveningness preference was predictive of poorer sleep quality regardless the influence of depressive symptoms. Conclusion Our findings suggest that eveningness and sleep complaints are predictive of affective dysfunctions, and should be carefully considered in the evaluation and treatment of OCD patients.
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Affiliation(s)
- Péter Simor
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - András Harsányi
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - Kata Csigó
- Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions, Budapest, Hungary
| | | | - Alpár Sándor Lázár
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Gyula Demeter
- Department of Cognitive Sciences, Budapest University of Technology and Economics, Budapest, Hungary
- Rehabilitation Department of Brain Injuries, National Institute of Medical Rehabilitation, Budapest, Hungary
- Learning and Memory Disorders Research Group, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
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22
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Dolsen EA, Harvey AG. Dim Light Melatonin Onset and Affect in Adolescents With an Evening Circadian Preference. J Adolesc Health 2018; 62:94-99. [PMID: 29056434 PMCID: PMC5742032 DOI: 10.1016/j.jadohealth.2017.07.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/21/2017] [Accepted: 07/21/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE A shift toward an evening circadian preference and the onset of mood problems often occur during adolescence. Although these changes are linked to poorer outcomes, few studies have considered how positive and negative affect are related to the circadian rhythm during adolescence. This study examined the relationship between evening and morning affect ratings and dim light melatonin onset (DLMO), a measure of endogenous circadian rhythm. Age and sex were tested as moderators. METHODS This study is based on a subset of 163 (94 female, age = 14.7) adolescents with an evening circadian preference from a National Institute of Child Health and Human Development-funded study. Participants provided saliva for melatonin analysis and rated evening and morning affect. RESULTS Higher evening negative affect was related to a later DLMO. Evening positive affect was not significantly related to DLMO timing. Age but not sex was a significant moderator such that higher negative and lower positive affect were related to a later DLMO for 10- to 13-year-olds, whereas higher positive affect was related to a later DLMO for 17- to 18-year-olds. DLMO was not significantly related to morning affect ratings. CONCLUSIONS There is evidence that higher negative and lower positive affect may be related to the shift toward an evening circadian preference observed in adolescents, particularly for younger adolescents.
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Affiliation(s)
- Emily A. Dolsen
- Department of Psychology, University of California, Berkeley,
USA
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