1
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Sperry SH, Boland EM, Burgess HJ, Gonzalez R, Gonzalez S, Lane JM, McCarthy MJ, McInnis MG, Yocum AK, Menkes MW, Gehrman PR. Bipolar disorder is characterized by chronotype instability: A longitudinal investigation of circadian typology and mood. Psychiatry Res 2024; 340:116123. [PMID: 39146617 DOI: 10.1016/j.psychres.2024.116123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/30/2024] [Accepted: 08/04/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Chronotype is associated with circadian rhythmicity, a core etiological factor underlying bipolar disorder (BD). Given converging evidence linking late chronotype with poor mental health, the goal of the present study was to examine chronotype (in)stability and its relation to mood symptoms over time. METHODS Participants with BD I (n = 271), BD II (n = 88), and healthy controls (n = 217) were included (follow-upM=10 years, Range=5-15) from the Prechter Longitudinal Study. Chronotype category and midpoint of sleep, corrected for weekend sleep-debt (MSFsc), were measured with the Munich Chronotype Questionnaire administered every 12 months alongside clinician-rated mood and medication usage. Self-reported mood was measured bi-monthly. Mixed effects models tested whether mood was associated with (in)stability of chronotype category and MSFsc covarying for age, sex, age, and medication. RESULTS Compared to HC, individuals with BD self-reported having a later chronotype that significantly fluctuated over time. Individuals with BDI showed significantly less stability in MSFsc than HC. Anticonvulsant use was associated with more stability in MSFsc whereas antidepressant use was associated with less stability in MSFsc. CONCLUSIONS In a large longitudinal cohort, individuals with BD displayed significant instability in circadian typology. Psychopharmacology in BD may have differential impacts on circadian timing that is important to monitor.
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Affiliation(s)
| | - Elaine M Boland
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, USA; Corporal Michael J. Crescenz VA Medical Center, USA
| | | | | | - Suzanne Gonzalez
- Department of Psychiatry, Huck Institutes of the Life Sciences, Penn State, USA
| | - Jacqueline M Lane
- Department of Sleep and Circadian Disorders, Mass General Brigham, USA
| | - Michael J McCarthy
- University of California San Diego Department of Psychiatry and Center for Circadian Biology, USA; VA San Diego Healthcare System, USA
| | | | | | | | - Philip R Gehrman
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, USA; Corporal Michael J. Crescenz VA Medical Center, USA
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2
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Cox RC, Wright KP, Axelsson J, Balter LJT. Diurnal variation in anxiety and activity is influenced by chronotype and probable anxiety-related disorder status. Psychiatry Res 2024; 338:116006. [PMID: 38850890 DOI: 10.1016/j.psychres.2024.116006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/12/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
Anxiety symptoms vary moment-to-moment within a day. One factor that may influence these variations is chronotype. Evening chronotypes prefer to engage in activities (e.g., sleep, physical and social activity) later in the day, and evening chronotype is implicated in psychopathology, including anxiety-related disorders. However, it is unknown whether chronotype influences diurnal variation in anxiety symptoms and whether these effects are amplified in individuals with a probable anxiety-related disorder. We examined the diurnal variation in anxiety symptoms and daily activities in morning and evening chronotypes with and without probable generalized anxiety disorder (GAD) or obsessive-compulsive disorder (OCD) in a community sample of adults (N = 410). Evening chronotypes reported higher anxiety symptoms, particularly in the evening hours, and lower engagement in daily activities, predominantly in the morning hours. Evening chronotypes with probable GAD or OCD reported worse anxiety symptoms in the evening. Our findings indicate that anxiety symptoms and engagement in daily activities fluctuate considerably across the day, and these patterns differ depending on chronotype. Evening chronotypes have more anxiety symptoms in the evening, despite preferring this time of day. Personalized treatment approaches that consider chronotype and target certain times of day may be efficient in alleviating peaks in anxiety symptoms.
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Affiliation(s)
- Rebecca C Cox
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - John Axelsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 65, Sweden; Department of Psychology, Stress Research Institute, Stockholm University, Stockholm 114 19, Sweden
| | - Leonie J T Balter
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm 171 65, Sweden; Department of Psychology, Stress Research Institute, Stockholm University, Stockholm 114 19, Sweden.
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3
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Ajeebi Y, Oberi IA, Al-Hulaibi M, Omair BA, Alsum GF, Abukhairat SM, Abualgasem OM, Gosadi IM. Assessment of Chronotype Distribution Among University Students and Its Association With Lifestyle Characteristics and Academic Performance. Cureus 2024; 16:e67678. [PMID: 39314594 PMCID: PMC11419403 DOI: 10.7759/cureus.67678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Chronotype is associated with the timing of peak physical and mental performance and activity levels. University students may experience changes in their chronotype, influencing their daytime activity and academic performance. This study aims to assess the distribution of chronotypes among a sample of university students from southern Saudi Arabia, examining its association with demographic, academic, and lifestyle factors. METHODS A cross-sectional study was conducted at Jazan University, located in the southwestern region of Saudi Arabia, between February and March 2023. Data collection was carried out using a structured questionnaire comprising three main components: demographic and academic data of participants, lifestyle characteristics, and an assessment of chronotype using the reduced version of the Horne and Östberg morningness-eveningness questionnaire. Associations between chronotype and demographic/lifestyle characteristics were analyzed using Pearson's chi-squared test or Fisher's exact test. RESULTS The study included 507 students. The mean age of the participants was 22 years (standard deviation: 2.07), with over half being male 277 (54.6%). The chronotype assessment indicated that 139 (27.4%) of students were morning types, 112 (22.1%) evening types, and 256 (50.5%) were neither type. Statistically significant variations in chronotypes were found in relation to the year of study, perceived influence of sleep habits on academic performance, meal frequency, consumption of fast food and certain caffeinated beverages, and smoking or Khat chewing habits (P < 0.05). CONCLUSION The findings suggest that an unhealthy lifestyle and the use of certain stimulants can influence chronotypes. Students with an evening chronotype should be a focus for university health services, allowing early identification and counseling to mitigate the negative impact of a disturbed chronotype on academic performance and reduce the risk of study-related stress.
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Affiliation(s)
- Yara Ajeebi
- College of Medicine, Jazan University, Jazan, SAU
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4
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Magnusdottir S, Magnusdottir I, Gunnlaugsdottir AK, Hilmisson H, Hrolfsdottir L, Paed AEEM. Sleep duration and social jetlag in healthy adolescents. Association with anxiety, depression, and chronotype: a pilot study. Sleep Breath 2024; 28:1541-1551. [PMID: 38546939 DOI: 10.1007/s11325-024-03026-z] [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: 12/05/2023] [Revised: 01/23/2024] [Accepted: 03/20/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE Misalignment between sleep opportunity and chronotype preference during adolescence may affect sleep and mental health. The aim of this study was to objectively evaluate sleep duration and social jetlag (SJL) to observe if there is a relationship with anxiety, depression, or chronotype. METHODS Community based cohort study (n = 65) was conducted in Northern Europe. Participants recorded their sleep during the regular school schedule for 3 school nights and 2 free nights with FDA-cleared/EU Medical Device Directive (CE-02862) compliant home sleep test. They also completed validated questionnaires to assess (Morningness Eveningness Questionnaire; MEQ), sleepiness (Epworth Sleepiness Scale; ESS), and insomnia (Insomnia Severity Index; ISI), anxiety (General Anxiety Disorder-7; GAD-7), and depression symptoms (Beck's Depression Inventory-II; BDI-II). Data were collected during the last week of February and the first 2 weeks of March, 2023. RESULTS Average sleep duration on school nights was 7 h, 15 min, with 18% of participants on average sleeping ≥ 8 h. Average sleep onset was significantly later on free nights (1 hour, 47 minutes; p < 0.0001) causing a high prevalence of moderate-severe SJL, in 71% of participants. Evening chronotypes (prevalence 15.4%) fell asleep later on free nights, causing them to have significantly more SJL (2 hours, 58 minutes) than morning chronotypes (1 hour, 32 minutes) and intermediary chronotypes (1 hour, 36 minutes). Evening chronotypes also had more severe insomnia (ISI + 4.4, p = 0.006; + 4.0, p = 0.001) and greater depressive symptoms (BDI-II + 21.6, p < 0.0001; + 17.1, p < 0.0001). A significant negative correlation was observed between MEQ scores and ESS (r = - 0.287; p = 0.001), ISI (r = - 0.343, p < 0.0001), GAD-7 (r = - 0.185, p < 0.0001), BDI-II (r = - 0.501, p = 0.0001), and suicidal thoughts (r = - 0.294, p = 0.017). CONCLUSION Adolescents are sleep-deprived and have a high prevalence of SJL that is positively correlated with depressive symptoms and evening chronotype. That evening chronotypes have shorter sleep duration, more severe SJL, and significantly more sleepiness and insomnia, anxiety, and depressive symptoms may indicate possible benefits in identifying this group with the aim to assist them in improving their sleep habits with potentially positive effects on mental health.
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Affiliation(s)
| | | | - Audur Karen Gunnlaugsdottir
- Akureyri Junior College, Akureyri, Iceland
- University of Akureyri, Akureyri, Iceland
- The Healthcare Institution of North Iceland, Husavik, Iceland
| | - Hugi Hilmisson
- MyCardio LLC, 3200 East Cherry Creek South Drive, Denver, CO, 80209, USA
| | - Laufey Hrolfsdottir
- Institution of Health Science Research, University of Akureyri and Akureyri Hospital, Akureyri, Iceland
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5
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Hu S, Wang F, Huang Q, Chen Y, Lyu D, Zhou N, Wang M, Zhang M, Xu C, Mueller I, Yao G, Liu X, Zhang Q, Hong W. Eveningness is associated with more severe depressive symptoms independently of sleep quality and fatigue level only in first-episode but not recurrent depression in major depressive disorder. Chronobiol Int 2024; 41:987-995. [PMID: 39007882 DOI: 10.1080/07420528.2024.2378958] [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: 01/14/2024] [Revised: 06/24/2024] [Accepted: 07/07/2024] [Indexed: 07/16/2024]
Abstract
People with an evening chronotype have an increased risk of experiencing a major depressive disorder (MDD). It is unclear if this effect is predominantly related to the initial development of MDD or also present in recurrent episodes. The current study aimed to investigate if the association between chronotype and depressive severity in MDD patients is comparable in MDD patients with first and recurrent episodes. 386 MDD patients, 70.7% females and aged between 16 and 64, participated in the study. The Morningness - Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Fatigue Inventory (MFI20), and Quick Inventory of Depressive Symptomatology (QIDS-SR16) were administered to participants to determine chronotype, sleep quality, fatigue level, and depressive severity, respectively. Multivariate regression models were utilized to analyze how chronotype influences depressive severity. The study showed that chronotype, sleep quality, and fatigue level were all associated with depressive severity. Eveningness significantly predicted an increase in depressive severity independently of sleep quality and fatigue level only in patients with the first episode (-0.068, p = 0.010), but not in patients with recurrent episodes (0.013, p = 0.594). Circadian-focused treatment should be considered in first-episode depression only.
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Affiliation(s)
- Shuang Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinte Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiming Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongbin Lyu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ni Zhou
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Division of Mood Disorders, Hongkou District Mental Health Center of Shanghai, Shanghai, China
| | - Meiti Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengke Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuchen Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ivo Mueller
- Population Health and Immunity, Walter and Eliza Hall Institute, Parkville, Victoria, Australia
- School of Global Health, Chinese Centre for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanqun Yao
- School of Medicine, Tsinghua University, Beijing, China
| | - Xirui Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinting Zhang
- Shanghai Key Lab of Forensic Medicine, Key Lab of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Mental Health Branch, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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6
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Michielsen M, Böhmer MN, Vermeulen RCH, Vlaanderen JJ, Beekman ATF, Kooij JJS. ADHD, sleep, chronotype and health in a large cohort of Dutch nurses. J Psychiatr Res 2024; 174:159-164. [PMID: 38636152 DOI: 10.1016/j.jpsychires.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/05/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Affiliation(s)
- M Michielsen
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands.
| | - M N Böhmer
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands
| | - R C H Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - J J Vlaanderen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Jenalaan 18d, 3584 CK, Utrecht, Utrecht, the Netherlands
| | - A T F Beekman
- Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
| | - J J S Kooij
- PsyQ, Expertise Center Adult ADHD, Carel Reinierszkade 197, 2593 HR, The Hague, the Netherlands; Department of Psychiatry and Amsterdam Public Health Research Institute, Amsterdam University Medical Center/VUmc, Oldenaller 1, 1081 HL, Amsterdam, the Netherlands
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7
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Que J, Chen S, Chan NY, Wu S, Zhang L, Chen Y, Liu J, Chen M, Chen L, Li SX, Lin D, Liu F, Wing YK. Associations of evening-type and insomnia symptoms with depressive symptoms among youths. Sleep Med 2024; 118:81-87. [PMID: 38626648 DOI: 10.1016/j.sleep.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/23/2024] [Accepted: 04/06/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Evening-type and insomnia symptoms are significantly related to each other and independently associated with depressive symptoms, yet few studies have examined the potential interaction between these two conditions. Therefore, we aimed to examine the associations of evening-type and insomnia symptoms with depressive symptoms among Chinese youths, with a specific focus on the joint effects of the two conditions on depressive symptoms. METHODS Participants aged between 12 and 25 were invited to participate in an online survey from December 15, 2022, to May 26, 2023. Multivariate logistic regression models and additive interaction models were used to examine the independent and joint effects of chronotypes and insomnia symptoms on depressive symptoms, respectively. RESULTS Of the 6145 eligible youths, the prevalence of evening-type and insomnia symptoms were 24.9 % and 29.6 %, respectively. Both evening-type (adjusted OR, [AdjOR]: 3.21, 95 % CI: 2.80-3.67) and insomnia symptoms (AdjOR: 10.53, 95 % CI: 9.14-12.12) were associated with an increased risk of depressive symptoms. In addition, the additive interaction models showed that there is an enhanced risk of depression related to interaction between evening-type and insomnia symptoms (relative excess risk due to interaction, [RERI]: 11.66, 95 % CI: 7.21-16.11). CONCLUSIONS The present study provided additional evidence demonstrating the presence of interaction between evening-type and insomnia symptoms, which can lead to a higher risk of depressive symptoms. Our findings argue the need for addressing both sleep and circadian factors in the management of depressive symptoms in young people.
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Affiliation(s)
- Jianyu Que
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Sijing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Suying Wu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Li Zhang
- Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China
| | - Yaoyi Chen
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Jingrou Liu
- Xiamen University of Technology, Xiamen, Fujian, China
| | | | - Lixia Chen
- Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region of China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Duoduo Lin
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
| | - Farong Liu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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8
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Dell'Acqua C, Messerotti Benvenuti S, Cellini N, Brush CJ, Ruggerone A, Palomba D. Familial risk for depression is associated with reduced physical activity in young adults: evidence from a wrist-worn actigraphy study. Transl Psychiatry 2024; 14:219. [PMID: 38806490 PMCID: PMC11133440 DOI: 10.1038/s41398-024-02925-9] [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] [Received: 11/23/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024] Open
Abstract
Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease. While a few studies have suggested that self-reported reduced physical activity and sleep-wake cycle disturbances might both be linked to depression vulnerability, actigraphy-based measures in vulnerable samples remain largely unexplored. This study relied on actigraphy-based parameters to test whether these disturbances characterize depression vulnerability. Seven-day actigraphy data were collected from 20 (13 female) university students with a high vulnerability to depression, which was determined by the presence of a family history of the condition but no current symptoms, and 32 (21 female) controls with neither a family history of depression nor current depressive symptoms. Daily physical activity, namely gross motor activity, was quantified as average daily acceleration and time spent engaging in moderate-vigorous physical activity (MVPA). The sleep-wake cycle and circadian rhythms were assessed as total sleep duration per night (in hours), sleep within sleep period time (in hours), sleep efficiency (%), and relative amplitude (i.e., the difference between the activity during the day and the night, which reflects circadian rhythms amplitude). Results showed that individuals with a familial risk for depression exhibited reduced daily acceleration and time spent in MVPA relative to the control group, particularly on the weekend during their free time away from scheduled activities. On the other hand, the two groups were comparable in terms of sleep estimates. Taken together, reduced physical activity, but not sleep-wake disturbances, seem to be associated with vulnerability to depression and might be a viable target for identification and prevention efforts.
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Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychology, University of Padua, Padua, Italy.
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
- Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - C J Brush
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | | | - Daniela Palomba
- Department of General Psychology, University of Padua, Padua, Italy
- Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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9
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Minbay M, Khan A, Ghasemi AR, Ingram KK, Ay AA. Sex-specific associations between circadian-related genes and depression in UK Biobank participants highlight links to glucose metabolism, inflammation and neuroplasticity pathways. Psychiatry Res 2024; 337:115948. [PMID: 38788553 DOI: 10.1016/j.psychres.2024.115948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/18/2024] [Accepted: 05/01/2024] [Indexed: 05/26/2024]
Abstract
Depressive disorders have increased in global prevalence, making improved management of these disorders a public health priority. Prior research has linked circadian clock genes to depression, either through direct interactions with mood-related pathways in the brain or by modulating the phase of circadian rhythms. Using machine learning and statistical techniques, we explored associations between 157,347 SNP variants from 51 circadian-related genes and depression scores from the patient health questionnaire 9 (PHQ-9) in 99,939 UK Biobank participants. Our results highlight multiple pathways linking the circadian system to mood, including metabolic, monoamine, immune, and stress-related pathways. Notably, genes regulating glucose metabolism and inflammation (GSK3B, LEP, RORA, and NOCT) were prominent factors in females, in addition to DELEC1 and USP46, two genes of unknown function. In contrast, FBXL3 and DRD4 emerged as significant risk factors for male depression. We also found epistatic interactions involving RORA, NFIL3, and ZBTB20 as either risk or protective factors for depression, underscoring the importance of transcription factors (ZBTB20, NFIL3) and hormone receptors (RORA) in depression etiology. Understanding the complex, sex-specific links between circadian genes and mood disorders will facilitate the development of therapeutic interventions and enhance the efficacy of multi-target treatments for depression.
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Affiliation(s)
- Mete Minbay
- Department of Computer Science, Colgate University, Hamilton, NY, USA
| | - Ayub Khan
- Department of Computer Science, Colgate University, Hamilton, NY, USA; Department of Biology, Colgate University, Hamilton, NY, USA
| | - Ali R Ghasemi
- Department of Computer Science, Colgate University, Hamilton, NY, USA
| | - Krista K Ingram
- Department of Biology, Colgate University, Hamilton, NY, USA.
| | - Ahmet A Ay
- Department of Biology, Colgate University, Hamilton, NY, USA
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10
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Song YM, Jeong J, de Los Reyes AA, Lim D, Cho CH, Yeom JW, Lee T, Lee JB, Lee HJ, Kim JK. Causal dynamics of sleep, circadian rhythm, and mood symptoms in patients with major depression and bipolar disorder: insights from longitudinal wearable device data. EBioMedicine 2024; 103:105094. [PMID: 38579366 PMCID: PMC11002811 DOI: 10.1016/j.ebiom.2024.105094] [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: 10/02/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Sleep and circadian rhythm disruptions are common in patients with mood disorders. The intricate relationship between these disruptions and mood has been investigated, but their causal dynamics remain unknown. METHODS We analysed data from 139 patients (76 female, mean age = 23.5 ± 3.64 years) with mood disorders who participated in a prospective observational study in South Korea. The patients wore wearable devices to monitor sleep and engaged in smartphone-delivered ecological momentary assessment of mood symptoms. Using a mathematical model, we estimated their daily circadian phase based on sleep data. Subsequently, we obtained daily time series for sleep/circadian phase estimates and mood symptoms spanning >40,000 days. We analysed the causal relationship between the time series using transfer entropy, a non-linear causal inference method. FINDINGS The transfer entropy analysis suggested causality from circadian phase disturbance to mood symptoms in both patients with MDD (n = 45) and BD type I (n = 35), as 66.7% and 85.7% of the patients with a large dataset (>600 days) showed causality, but not in patients with BD type II (n = 59). Surprisingly, no causal relationship was suggested between sleep phase disturbances and mood symptoms. INTERPRETATION Our findings suggest that in patients with mood disorders, circadian phase disturbances directly precede mood symptoms. This underscores the potential of targeting circadian rhythms in digital medicine, such as sleep or light exposure interventions, to restore circadian phase and thereby manage mood disorders effectively. FUNDING Institute for Basic Science, the Human Frontiers Science Program Organization, the National Research Foundation of Korea, and the Ministry of Health & Welfare of South Korea.
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Affiliation(s)
- Yun Min Song
- Department of Mathematical Sciences, KAIST, Daejeon, 34141, Republic of Korea; Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea
| | - Jaegwon Jeong
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea
| | - Aurelio A de Los Reyes
- Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea; Institute of Mathematics, University of the Philippines Diliman, Quezon City, 1101, Philippines
| | - Dongju Lim
- Department of Mathematical Sciences, KAIST, Daejeon, 34141, Republic of Korea; Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea
| | - Chul-Hyun Cho
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea
| | - Ji Won Yeom
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea
| | - Taek Lee
- Division of Computer Science and Engineering, Sun Moon University, Asan, 31460, Republic of Korea
| | - Jung-Been Lee
- Division of Computer Science and Engineering, Sun Moon University, Asan, 31460, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, 02841, Republic of Korea; Chronobiology Institute, Korea University, Seoul, 02841, Republic of Korea.
| | - Jae Kyoung Kim
- Department of Mathematical Sciences, KAIST, Daejeon, 34141, Republic of Korea; Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea.
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11
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Oliveira CDS, Andrechuk CRS, Guimarães Lima M, Berti de Azevedo Barros M, Zancanella E, Marchiori de Oliveira Cardoso TA, Ceolim MF. Factors associated with the fragmentation and stability of the rest-activity rhythm in adults and older adults. Chronobiol Int 2024; 41:697-708. [PMID: 38682468 DOI: 10.1080/07420528.2024.2346521] [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: 12/14/2023] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
This cross-sectional study aimed to identify factors related to the fragmentation and stability of the rest-activity rhythm (RAR) in adults and older adults. It is part of a larger research project investigating aspects concerning sleep duration, quality, and disorders in a representative subsample of the population. Sociodemographic data, lifestyle, health habits and subjective sleep variables were obtained; RAR records were collected by means of actigraphy and analyzed using non-parametric variables (IS, IV, M10, L5, RA, sL5, and sM10). Study participants were 313 individuals with complete actigraphy records. There was a prevalence of older adults (50.2%) and females (51.1%). Females, individuals with 4-8 y of education, and those who used alcohol abusively exhibited lower RAR fragmentation. Higher fragmentation was observed in individuals who napped and those reporting poor sleep quality. Greater rhythm stability was evident in females, older adults, those with 4-8 y of education, and those who had a partner. Smokers demonstrated lower RAR stability. These findings may contribute valuable insights for decision-making aimed at preventing and treating issues related to fragmentation and instability of the rhythm and its possible consequences to health.
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Affiliation(s)
| | | | - Margareth Guimarães Lima
- Department of Collective Health, School of Medical Science, Campinas State University, Campinas, Brazil
| | | | - Edilson Zancanella
- Department of Otorhinolaryngology, School of Medical Science, Campinas State University, Campinas, Brazil
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12
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Li T, Cao Y, Zhou P, Xie Y, Tao S, Zou L, Yang Y, Tao F, Wu X. Prospective study of the association between chronotypes and depressive symptoms in Chinese university students: Moderating effects of PER1 gene DNA methylation. Chronobiol Int 2024; 41:621-631. [PMID: 38568246 DOI: 10.1080/07420528.2024.2337891] [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: 12/07/2023] [Accepted: 03/27/2024] [Indexed: 05/22/2024]
Abstract
Most studies have shown a link between chronotypes and mental health and have identified evening chronotypes (E-types) as a potential risk for depressive symptoms. However, the mechanisms behind this association remain unknown. Abnormal expression of the PER1 gene was not only associated with circadian rhythm disturbance, but also closely related to mental illness. Therefore, this study aimed to examine the association of chronotype with depressive symptoms, and further explore the moderating effects of the PER1 gene DNA methylation on chronotypes and depressive symptoms in Chinese university students. In a stratified cluster sampling design, chronotype and depressive symptoms were assessed in 1 042 university students from 2 universities in a two-year prospective survey from April 2019 to October 2020. The survey was conducted once every 6 months, corresponding to the time points in April 2019 (T0), October 2019 (T1), April 2020 (T2), and October 2020 (T3). At T0, the Morning and Evening Questionnaire 5 (MEQ-5) was adopted to assess chronotype. At T0-T3, the Patient Health Questionnaire 9 (PHQ-9) was adopted to investigate depressive symptoms. Meanwhile, at T0, participants were subjected to a health check-up trip in the hospital, and blood samples were taken from the students to measure the PER1 gene DNA methylation levels. Binary logistic regression was used to analyze the association of chronotypes with depressive symptoms. The depression/total depression group was coded as 1, while the remaining participants was defined as one group, and was coded as 0. The PROCESS plug-in of SPSS software was used to analyze the moderating effects of PER1 gene DNA methylation on the association of chronotype with depressive symptoms. After adjusting for covariates, the results indicated that T0 E-types were positively correlated with T0-T3 depression/total depression in female university students. Furthermore, the PER1 gene DNA methylation has negative moderating effects between T0 chronotype and T3 depressive symptoms and has a sex difference. This study can provide more favorable scientific value for the prevention and control of depression in university students.
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Affiliation(s)
- Tingting Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yuxuan Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Panfeng Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Shuman Tao
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, Anhui, China
| | - Liwei Zou
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, Anhui, China
| | - Yajuan Yang
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Anhui Medical University, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China
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13
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Zhu Y, Zhang R, Yin S, Sun Y, Womer F, Liu R, Zeng S, Zhang X, Wang F. Digital Dietary Behaviors in Individuals With Depression: Real-World Behavioral Observation. JMIR Public Health Surveill 2024; 10:e47428. [PMID: 38648087 DOI: 10.2196/47428] [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: 03/27/2023] [Revised: 09/02/2023] [Accepted: 03/01/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Depression is often accompanied by changes in behavior, including dietary behaviors. The relationship between dietary behaviors and depression has been widely studied, yet previous research has relied on self-reported data which is subject to recall bias. Electronic device-based behavioral monitoring offers the potential for objective, real-time data collection of a large amount of continuous, long-term behavior data in naturalistic settings. OBJECTIVE The study aims to characterize digital dietary behaviors in depression, and to determine whether these behaviors could be used to detect depression. METHODS A total of 3310 students (2222 healthy controls [HCs], 916 with mild depression, and 172 with moderate-severe depression) were recruited for the study of their dietary behaviors via electronic records over a 1-month period, and depression severity was assessed in the middle of the month. The differences in dietary behaviors across the HCs, mild depression, and moderate-severe depression were determined by ANCOVA (analyses of covariance) with age, gender, BMI, and educational level as covariates. Multivariate logistic regression analyses were used to examine the association between dietary behaviors and depression severity. Support vector machine analysis was used to determine whether changes in dietary behaviors could detect mild and moderate-severe depression. RESULTS The study found that individuals with moderate-severe depression had more irregular eating patterns, more fluctuated feeding times, spent more money on dinner, less diverse food choices, as well as eating breakfast less frequently, and preferred to eat only lunch and dinner, compared with HCs. Moderate-severe depression was found to be negatively associated with the daily 3 regular meals pattern (breakfast-lunch-dinner pattern; OR 0.467, 95% CI 0.239-0.912), and mild depression was positively associated with daily lunch and dinner pattern (OR 1.460, 95% CI 1.016-2.100). These changes in digital dietary behaviors were able to detect mild and moderate-severe depression (accuracy=0.53, precision=0.60), with better accuracy for detecting moderate-severe depression (accuracy=0.67, precision=0.64). CONCLUSIONS This is the first study to develop a profile of changes in digital dietary behaviors in individuals with depression using real-world behavioral monitoring. The results suggest that digital markers may be a promising approach for detecting depression.
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Affiliation(s)
- Yue Zhu
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Ran Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
| | - Shuluo Yin
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Yihui Sun
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
- School of Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Fay Womer
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Rongxun Liu
- Henan Key Laboratory of Immunology and Targeted Drug, Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, School of Laboratory Medicine, Xinxiang Medical University, Xinxiang, China
| | - Sheng Zeng
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
- School of Computer Science and Engineering, Northeastern University, Shenyang, China
| | - Xizhe Zhang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, China
| | - Fei Wang
- Early Intervention Unit, Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, China
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14
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Li SX, Cheung FTW, Chan NY, Chan JWY, Zhang J, Li AM, Espie CA, Gradisar M, Wing YK. Effects of cognitive behavioural therapy and bright light therapy for insomnia in youths with eveningness: study protocol for a randomised controlled trial. Trials 2024; 25:246. [PMID: 38594725 PMCID: PMC11005158 DOI: 10.1186/s13063-024-08090-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Insomnia and eveningness are common and often comorbid conditions in youths. While cognitive behavioural therapy for insomnia (CBT-I) has been suggested as a promising intervention, it remains unclear whether it is sufficient to also address circadian issues in youths. In addition, despite that light has been shown to be effective in phase-shifting one's circadian rhythm, there has been limited data on the effects of bright light therapy and its combination with CBT-I on sleep and circadian outcomes in youths. The current protocol outlines a randomised controlled trial that examines the efficacy of CBT-I and CBT-I plus bright light therapy (BLT) in reducing insomnia severity, improving mood symptoms and daytime functioning (e.g. sleepiness, fatigue, cognitive function), and improving subjective and objective sleep and circadian measures compared to a waitlist control group. METHODS We will carry out a randomised controlled trial (RCT) with 150 youths aged 12-24 who meet the criteria of insomnia and eveningness. Participants will be randomised into one of three groups: CBT-I with bright light therapy, CBT-I with placebo light, and waitlist control. Six sessions of CBT-I will be delivered in a group format, while participants will be currently asked to use a portable light device for 30 min daily immediately after awakening throughout the intervention period for bright light therapy. The CBT-I with light therapy group will receive bright constant green light (506 lx) while the CBT-I with placebo light group will receive the modified light device with the LEDs emitting less than 10 lx. All participants will be assessed at baseline and post-treatment, while the two active treatment groups will be additionally followed up at 1 month and 6 months post-intervention. The primary outcome will be insomnia severity, as measured by the Insomnia Severity Index. Secondary outcomes include self-reported mood, circadian, daytime functioning, and quality of life measures, as well as sleep parameters derived from actigraphy and sleep diary and neurocognitive assessments. Objective measures of the circadian phase using dim-light melatonin onset assessment and sleep parameters using polysomnography will also be included as the secondary outcomes. DISCUSSION This study will be the first RCT to directly compare the effects of CBT-I and BLT in youths with insomnia and eveningness. Findings from the study will provide evidence to inform the clinical management of insomnia problems and eveningness in youths. TRIAL REGISTRATION ClinicalTrials.gov NCT04256915. Registered on 5 February 2020.
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Affiliation(s)
- Shirley Xin Li
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Forrest Tin Wai Cheung
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Colin A Espie
- Nuffield Department of Clinical Neurosciences and Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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15
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Güleç A, Güler HA, Türkoğlu S. Relationship between Traumatic Experiences, Circadian Preference and ADHD Symptoms in Adolescents with ADHD Residing in Institutional Care: A Controlled Study. Chronobiol Int 2024; 41:495-503. [PMID: 38375810 DOI: 10.1080/07420528.2024.2319218] [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: 09/28/2023] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Circadian preference, describes biological and behavioural characteristics that influence the ability to plan daily activities according to optimal waking times. It is divided into three main categories: morning, evening and intermediate. In particular, the evening chronotype is associated with conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Post Traumatic Stress Disorder (PTSD). This study was conducted in three groups aged 14-18 years: The first group consisted of 34 adolescents diagnosed with ADHD who had been in institutional care for at least two years and had not used medication in the last six months. The second group included 29 adolescents with ADHD living with their families who had not used medication in the last six months. The third control group consisted of 32 healthy adolescents. The study utilized sociodemographic data forms, the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S) to measure ADHD symptoms, the Childhood Chronotype Questionnaire (CCQ), and the Childhood Trauma Questionnaire (CTQ). In institutionalized adolescents with diagnosed ADHD, ADHD and disruptive behavior symptoms were more severe. Increased trauma scores were associated with higher ADHD and disruptive behaviour symptom severity and evening chronotype. In the conducted mediation analysis, evening chronotype was identified as a full mediator in the relationship between trauma symptoms and ADHD symptoms, while it was determined as a partial mediator in the relationship between trauma symptoms and PTSD symptoms. In conclusion, traumatic experiences in institutionalized adolescents with diagnosed ADHD may exacerbate ADHD and disruptive behavior symptoms. Evening chronotype is associated with ADHD and disruptive behavior symptoms, and therefore, the chronotypes of these adolescents should be assessed. Chronotherapeutic interventions may assist in reducing inattention, hyperactivity, and behavioral problems.
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Affiliation(s)
- Ahmet Güleç
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selçuk University, Konya, Türkiye
| | - Hasan Ali Güler
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selçuk University, Konya, Türkiye
| | - Serhat Türkoğlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Selçuk University, Konya, Türkiye
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16
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Üzer A, Uran C, Yılmaz E, Şahin ŞN, Ersin MK, Yılmaz RH, Çıkla A. The relationship between chronotype, psychological pain, problematic social media use, and suicidality among university students in Turkey. Chronobiol Int 2024; 41:504-512. [PMID: 38373906 DOI: 10.1080/07420528.2024.2320226] [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: 07/28/2023] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
Chronotype has been extensively linked to various psychological outcomes, including suicide, which significantly impacts the mortality rate among young adults worldwide. Research on the extent of these links is still ongoing. This cross-sectional study aimed to explore the complex relationships between chronotype, internet addiction, problematic social media use (PSMU), psychological pain, and suicidality in a student population. A total of 571 Turkish students (65.3% female, mean age 20.3 ± 1.63 years) completed the following scales: the Suicide Probability Scale (SPS), the Mee-Bunney Psychological Pain Assessment Scale (MBPPAS), the Social Media Disorder Scale (SMDS), the Internet Addiction Test (IAT), the Morningness - Eveningness Questionnaire (MEQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the relationship between chronotype and suicidality was partially mediated by SMDS and MBPPAS but not by anxiety, depression, or IAT. These findings suggest that psychological pain and PSMU may be important factors that contribute to suicidality in evening-type individuals. These findings have significant implications for the development of interventions aimed at reducing suicidality among evening-type individuals. By addressing the underlying factors of psychological pain and PSMU, it may be possible to mitigate the increased risk of suicidality among this population.
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Affiliation(s)
- Ahmet Üzer
- Faculty of Medicine, Department of Psychiatry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ceren Uran
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Elif Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Şeima Nur Şahin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Muhammet Kaan Ersin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Rohat Hasret Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ayça Çıkla
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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17
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Polańska S, Karykowska A, Pawelec Ł. Associations between chronotype and physical activity and well-being in adults. Chronobiol Int 2024; 41:521-529. [PMID: 38410867 DOI: 10.1080/07420528.2024.2321942] [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: 04/06/2023] [Accepted: 02/18/2024] [Indexed: 02/28/2024]
Abstract
Circadian rhythms influence a preference for people's time of activity and sleep time during the day and the hours of best performance. The aim of the study was to assess the associations between chronotype, physical activity, and well-being in adults aged 20-50. The chronotype, physical activity and well-being scores were determined based on the Composite Scale of Morningness (CSM) questionnaire, the International Physical Activity Questionnaire (IPAQ) and the Well-Being Index (WHO-5) questionnaire, respectively. Study data consisted of the answers of 213 respondents (including 64 men) who took part in an online survey. The Spearman rank correlation coefficient and the matrix scatter plots were used to check the correlations between the CSM score and quality of life parameters' values. General linear models (GLMs) were performed to find differences in quality-of-life parameters between different combinations of sex and chronotype. Morning types showed the highest value of well-being score (mean = 13.48) while evening types the lowest one (mean = 8.35). Evening types spent the most time sitting compared to other chronotypes. Results of this study revealed the significant effect of chronotype on well-being and physical activity among adults. These findings suggest that chronotype is an important factor that psychologists and personal trainers should take into account.
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Affiliation(s)
- Sara Polańska
- Division of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, ul. Kożuchowska 5, Wrocław, Poland
| | - Aleksandra Karykowska
- Division of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, ul. Kożuchowska 5, Wrocław, Poland
| | - Łukasz Pawelec
- Division of Anthropology, Institute of Environmental Biology, Wroclaw University of Environmental and Life Sciences, ul. Kożuchowska 5, Wrocław, Poland
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18
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Poon K, Ho MSH, Tai APL, Leung MK, Chan MCM, Lau WKW. Mediating roles of sleep quality and resilience in the relationships between chronotypes and mental health symptoms. Sci Rep 2024; 14:5874. [PMID: 38467740 PMCID: PMC10928116 DOI: 10.1038/s41598-024-56688-w] [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: 11/23/2023] [Accepted: 03/09/2024] [Indexed: 03/13/2024] Open
Abstract
Sleep and mental health are intrinsically intertwined, but not every individual with problems sleeping develops a mental health disorder. This study examined the association among chronotypes, resilience, sleep quality and mental health symptoms amongst otherwise healthy individuals. Two hundred adults (Mage = 27.75 ± 5.11, 68% female) with no previous diagnosis of mental illness were recruited and filled in a set of questionnaires measuring chronotypes, sleep quality, depression and anxiety symptoms. The findings from the path analysis showed that the morning type had a statistically significant direct effect on a range of sleep quality indices. These included better subjective sleep quality, shortened sleep latency, and fewer daytime dysfunctions, as well as a higher level of resilience. However, it did not significantly affect depression and anxiety symptoms. In addition, the morning type had statistically significant indirect effects on a higher level of resilience and fewer depression and anxiety symptoms through the mediating effect of sleep quality indices. Findings from this study support that morning type is associated with better resilience and psychological health, which is mediated through better sleep quality.
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Affiliation(s)
- Kean Poon
- School of Education, The University of New South Wales, Sydney, Australia
| | - Mimi S H Ho
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China
| | - Alan P L Tai
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China
| | - Mei-Kei Leung
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Meanne C M Chan
- Wofoo Joseph Lee Consulting and Counselling Psychology Research Centre, Lingnan University of Hong Kong, Room 213, LBY Building, 8 Castle Peak Road, Tuen Mun, Hong Kong, China.
| | - Way K W Lau
- Department of Health Sciences, Hong Kong Metropolitan University, Room F1229, 12/F, 1 Sheung Shing Street, Ho Man Tin, Kowloon, Hong Kong, China.
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19
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Yan R, Marshall T, Khullar A, Nagle T, Knowles J, Malkin M, Chubbs B, Swainson J. Patient-reported outcomes on sleep quality and circadian rhythm during treatment with intravenous ketamine for treatment-resistant depression. Ther Adv Psychopharmacol 2024; 14:20451253241231264. [PMID: 38440104 PMCID: PMC10910882 DOI: 10.1177/20451253241231264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/18/2024] [Indexed: 03/06/2024] Open
Abstract
Background Intravenous (IV) ketamine is a rapid acting antidepressant used primarily for treatment-resistant depression (TRD). It has been suggested that IV ketamine's rapid antidepressant effects may be partially mediated via improved sleep and changes to the circadian rhythm. Objectives This study explores IV ketamine's association with changes in patient-reported sleep quality and circadian rhythm in an adult population with TRD. Methods Adult patients (18-64 years) with TRD scheduled for IV ketamine treatment were recruited to complete patient rated outcomes measures on sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and circadian rhythm using the Morningness-Eveningness Questionnaire (MEQ). Over a 4-week course of eight ketamine infusions, reports were obtained at baseline (T0), prior to second treatment (T1), prior to fifth treatment (T2), and 1 week after eighth treatment (T3). Results Forty participants with TRD (mean age = 42.8, 45% male) were enrolled. Twenty-nine (72.5%) had complete follow-up data. Paired t tests revealed statistically significant improvements at the end of treatment in sleep quality (PSQI) (p = 0.003) and depressive symptoms (Clinically Useful Depression Outcome Scale-Depression, p < 0.001) while circadian rhythm (MEQ) shifted earlier (p = 0.007). The PSQI subscale components of sleep duration (p = 0.008) and daytime dysfunction (p = 0.001) also improved. In an exploratory post hoc analysis, ketamine's impact on sleep quality was more prominent in patients with mixed features, while its chronobiotic effect was prominent in those without mixed features. Conclusion IV ketamine may improve sleep quality and advance circadian rhythm in individuals with TRD. Effects may differ in individuals with mixed features of depression as compared to those without. Since this was a small uncontrolled study, future research is warranted.
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Affiliation(s)
- Raymond Yan
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Atul Khullar
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Travis Nagle
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jake Knowles
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Mai Malkin
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Brittany Chubbs
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer Swainson
- Cabrini Center, 3rd Floor, 16811-88 Ave NW, Edmonton, AB, Canada T5R 5YR
- Department of Psychiatry, University of Alberta, Canada
- Misericordia Community Hospital, Edmonton, Alberta, Canada
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20
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Walsh RFL, Maddox MA, Smith LT, Liu RT, Alloy LB. Social and circadian rhythm dysregulation and suicide: A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 158:105560. [PMID: 38272337 PMCID: PMC10982958 DOI: 10.1016/j.neubiorev.2024.105560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024]
Abstract
This systematic review of 52 studies provides a quantitative synthesis of the empirical literature on social and circadian rhythm correlates of suicidal thoughts and behaviors (STB). Small-to-medium pooled effect sizes were observed for associations between evening chronotype and STB and suicidal ideation (SI), although the pooled effect size diminished when accounting for publication bias. Three studies employed longitudinal designs and suggested eveningness was predictive of future STB, with a small-to-medium effect size. Social rhythm irregularity was also a significant correlate of STB with pooled effect sizes in the medium range. Overall circadian rhythm disruption was not associated with STB, although certain circadian rhythm metrics, including mean daytime activity, circadian rhythm sleep-wake disorder diagnosis, and actigraphy-assessed amplitude were associated with STB. Pooled effect sizes for these indices were in the medium to large range. There is a need for additional longitudinal research on actigraphy-based circadian parameters and objective markers of circadian phase (i.e., dim-light melatonin onset) to gain a clearer understanding of associations of endogenous circadian function and STB beyond that which can be captured via self-report.
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Affiliation(s)
- Rachel F L Walsh
- Department of Psychology and Neuroscience, Temple University, USA.
| | | | - Logan T Smith
- Department of Psychology and Neuroscience, Temple University, USA
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital, USA; Department of Psychiatry, Harvard Medical School, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, USA
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, USA
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21
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Benasi G, Mehr C, Liao M, Aggarwal B. The role of social support in the relation between chronotype and mental health in a cohort of women from the American Heart Association Go Red for Women Strategically Focused Research Network. Chronobiol Int 2024; 41:447-455. [PMID: 38320972 PMCID: PMC10993173 DOI: 10.1080/07420528.2024.2313649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
Women are disproportionally affected by psychological distress and lack of social support and are more vulnerable to the negative impact of chronotype on mental health. This study evaluates cross-sectional associations between chronotype and mental health, while assessing the mediating role of social support among women from diverse racial/ethnic backgrounds. Women from the American Heart Association Go Red for Women Research Network were included (N = 506, mean age = 37 ± 15.7, 61% racial/ethnic minority). Chronotype, depression, perceived stress, health-related quality of life, and social support were assessed at baseline using validated self-reported questionnaires. Linear regression and causal mediation analyses were performed. Depression and negative emotionality were higher among women with evening vs. morning/intermediate chronotypes (all p < 0.05). Multivariable analyses adjusted for sociodemographic and clinical confounders showed associations between evening chronotype and higher depression (p = 0.004) and negative emotionality (p = 0.010). However, these associations were no longer significant after adjusting for social support (depression: p = 0.12; negative emotionality: p = 0.18). Social support significantly mediated 44.6% and 45.8% of the total effect of chronotype on depression and negative emotionality, respectively. Social support represents a potential mechanism underlying the associations between eveningness and poor mental health. Chronotype and social support should be considered in interventions for the promotion of mental health in women.
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Affiliation(s)
- Giada Benasi
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Cole Mehr
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Ming Liao
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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22
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Badenhorst M, Brown J, Runciman P, Fliess-Douer O, Derman W. Promotion of Para Athlete Well-being (PROPEL II): A Cross-sectional Study of Sleep in Para Athletes Across Two Nations. Am J Phys Med Rehabil 2024; 103:261-270. [PMID: 37405902 DOI: 10.1097/phm.0000000000002306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Limited research exists on the sleep profiles of South African Para athletes. The aims of this study are to describe sleep quality, day-time sleepiness, and chronotype of South African Para athletes and to compare the relationship between sleep-related outcomes and demographic factors to athletes from a higher-resource country. DESIGN A descriptive, cross-sectional survey was conducted. Sleep-related characteristics were assessed with the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Morningness-Eveningness Questionnaire. Multiple regression models were run with and without country as independent variable. RESULTS One hundred twenty-four South African athletes and 52 Israeli athletes were included. Thirty percent of South African athletes presented with excessive daytime sleepiness, 35% slept 6 hrs or less per night, and 52% reported poor sleep quality. Thirty-three percent of Israeli athletes reported excessive daytime sleepiness, 29% slept 6 hrs or less, and 56% reported poor sleep quality. Chronotype was the only variable that differed significantly between countries (overrepresentation of morning types in South African athletes, and intermediate types in Israeli athletes). Intermediate chronotypes had significantly greater odds of excessive daytime sleepiness ( P = 0.007) and poor sleep quality ( P = 0.002) than morning types, irrespective of country. CONCLUSIONS The high prevalence of poor sleep among both South African and Israeli Para athletes warrants further investigation.
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Affiliation(s)
- Marelise Badenhorst
- From the Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa (MB, JB, PR, WD); International Olympic Committee (IOC) Research Center, South Africa (MB, JB, PR, WD); Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand (MB); Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, United Kingdom (JB); Israel Paralympic Committee, Tel Aviv, Israel (OFD); and Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, KU Leuven, Belgium (OFD)
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23
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van Rheede JJ, Alagapan S, Denison TJ, Riva-Posse P, Rozell CJ, Mayberg HS, Waters AC, Sharott A. Cortical signatures of sleep are altered following effective deep brain stimulation for depression. Transl Psychiatry 2024; 14:103. [PMID: 38378677 PMCID: PMC10879134 DOI: 10.1038/s41398-024-02816-z] [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] [Received: 11/03/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Deep brain stimulation (DBS) of the subcallosal cingulate cortex (SCC) is an experimental therapy for treatment-resistant depression (TRD). Chronic SCC DBS leads to long-term changes in the electrophysiological dynamics measured from local field potential (LFP) during wakefulness, but it is unclear how it impacts sleep-related brain activity. This is a crucial gap in knowledge, given the link between depression and sleep disturbances, and an emerging interest in the interaction between DBS, sleep, and circadian rhythms. We therefore sought to characterize changes in electrophysiological markers of sleep associated with DBS treatment for depression. We analyzed key electrophysiological signatures of sleep-slow-wave activity (SWA, 0.5-4.5 Hz) and sleep spindles-in LFPs recorded from the SCC of 9 patients who responded to DBS for TRD. This allowed us to compare the electrophysiological changes before and after 24 weeks of therapeutically effective SCC DBS. SWA power was highly correlated between hemispheres, consistent with a global sleep state. Furthermore, SWA occurred earlier in the night after chronic DBS and had a more prominent peak. While we found no evidence for changes to slow-wave power or stability, we found an increase in the density of sleep spindles. Our results represent a first-of-its-kind report on long-term electrophysiological markers of sleep recorded from the SCC in patients with TRD, and provides evidence of earlier NREM sleep and increased sleep spindle activity following clinically effective DBS treatment. Future work is needed to establish the causal relationship between long-term DBS and the neural mechanisms underlying sleep.
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Affiliation(s)
- Joram J van Rheede
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
| | - Sankaraleengam Alagapan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Timothy J Denison
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Institute for Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Christopher J Rozell
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Helen S Mayberg
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allison C Waters
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Sharott
- MRC Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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24
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Hasler BP, Wallace ML, Graves JL, Witt R, Guo K, Buysse DJ, Siegle GJ, Clark DB. Pre-pandemic circadian phase predicts pandemic alcohol use among adolescents. J Sleep Res 2024; 33:e13905. [PMID: 37039532 PMCID: PMC10564965 DOI: 10.1111/jsr.13905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023]
Abstract
Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depression and alcohol. We used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing showed improvements in sleep, depression and alcohol involvement. Participants were 42 adolescents reporting alcohol use. We assessed circadian phase via dim light melatonin onset prior to the pandemic, then conducted remote assessments of sleep, depressive symptoms and alcohol use during the pandemic. Mixed-effects models were used to test for pandemic effects, covarying for age, sex, time since baseline evaluation, and current school/work status. Adolescents with later circadian timing reported less sleep than other teens on school nights, both before and during the pandemic. Although school night sleep increased during the pandemic (F = 28.36, p < 0.001), those increases were not greater for individuals with later circadian timing. Individuals with later circadian timing reported larger increases in alcohol use than other teens during the pandemic (X2 = 36.03, p < 0.001). Depressive symptoms increased during the pandemic (X2 = 46.51, p < 0.001) but did not differ based on circadian timing. Consistent with prior reports, adolescents with later circadian timing obtained less sleep, and later school schedules facilitated increased sleep duration. Nonetheless, individuals with later circadian timing reported the sharpest increases in alcohol use, suggesting that circadian timing contributes to risk for alcohol use beyond the effects of insufficient sleep.
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Affiliation(s)
- Brant P. Hasler
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | | | - Jessica L. Graves
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Rachel Witt
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Kathryn Guo
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Daniel J. Buysse
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Greg J. Siegle
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Duncan B. Clark
- University of Pittsburgh School of Medicine, Department of
Psychiatry
- School of Pharmacy, Department of Pharmaceutical Sciences,
Pittsburgh, PA, USA
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25
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Aggarwal B, Benasi G, Makarem N, Mayat Z, Byun S, Liao M, Giardina EG. Psychosocial factors are associated with sleep disturbances and evening chronotype among women: A brief report from the American Heart Association Go Red for Women Strategically Focused Research Network. Sleep Health 2024; 10:65-68. [PMID: 38007300 PMCID: PMC10922278 DOI: 10.1016/j.sleh.2023.10.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVES To evaluate associations between psychosocial factors and sleep characteristics commonly linked to cardiovascular disease risk among racially/ethnically diverse women. METHODS Women from the AHA Go Red for Women cohort (N = 506, 61% racial/ethnic minority, 37 ± 16years) were assessed using self-reported questionnaires. Logistic regression models were adjusted for age, race, ethnicity, education, and insurance. RESULTS Women with depression had ∼3-fold higher odds of short sleep (95%CI=1.69-4.61), 2-fold higher odds of poor sleep quality and obstructive sleep apnea risk (95%CI=1.42-3.70 and 1.34-4.24), 4-fold higher odds of insomnia (95%CI=2.42-6.59), and greater likelihood of having an evening chronotype (OR:2.62, 95%CI=1.41-4.89). Low social support was associated with insomnia (OR:1.79, 95%CI=1.18-2.71) and evening chronotype (OR:2.38, 95%CI=1.35-4.19). Caregiving was associated with short sleep (OR:1.73, 95%CI=1.08-2.77) and obstructive sleep apnea risk (OR:2.46, 95%CI=1.43-4.22). CONCLUSIONS Depression, caregiver strain, and low social support are significantly associated with poor sleep and evening chronotype, highlighting a potential mechanism linking these psychosocial factors to cardiovascular disease risk.
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Affiliation(s)
- Brooke Aggarwal
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA; Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
| | - Giada Benasi
- Sleep Center of Excellence, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA; Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Zara Mayat
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Stephanie Byun
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ming Liao
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Elsa-Grace Giardina
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
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26
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Żebrowska M, Strohmaier S, Westgarth C, Huttenhower C, Eliassen HA, Haghayegh S, Huang T, Laden F, Hart J, Rosner B, Kawachi I, Chavarro JE, Okereke OI, Schernhammer ES. Timing and duration of dog walking and dog owner's chronotype in relation to incident depression risk among middle to older-aged female nurses. PLoS One 2024; 19:e0296922. [PMID: 38295024 PMCID: PMC10829988 DOI: 10.1371/journal.pone.0296922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND We examined associations between dog ownership, morning dog walking and its timing and duration, and depression risk in female nurses, exploring effect modification by chronotype. We hypothesized that dog ownership and morning walking with the dog are associated with lower odds of depression, and that the latter is particularly beneficial for evening chronotypes by helping them to synchronize their biological clock with the solar system. METHODS 26,169 depression-free US women aged 53-72 from the Nurses' Health Study 2 (NHS2) were prospectively followed from 2017-2019. We used age- and multivariable-adjusted logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for depression according to dog ownership, and morning dog walking, duration, and timing. RESULTS Overall, there was no association between owning a dog (ORvs_no_pets = 1.12, 95%CI = 0.91-1.37), morning dog walking (ORvs_not = 0.87, 95%CI = 0.64-1.18), or the duration (OR>30min vs. ≤15mins = 0.68, 95%CI = 0.35-1.29) or timing of morning dog walks (ORafter9am vs. before7am = 1.06, 95%CI = 0.54-2.05) and depression. Chronotype of dog owners appeared to modify these associations. Compared to women of the same chronotype but without pets, dog owners with evening chronotypes had a significantly increased odds of depression (OR = 1.60, 95%CI = 1.12-2.29), whereas morning chronotypes did not (OR = 0.94, 95%CI = 0.71-1.23). Further, our data suggested that evening chronotypes benefited more from walking their dog themselves in the morning (OR = 0.75, 95%CI = 0.46-1.23, Pintx = 0.064;) than morning chronotypes. CONCLUSIONS Overall, dog ownership was not associated with depression risk though it was increased among evening chronotypes. Walking their dog in the morning might help evening chronotypes to lower their odds of depression, though more data are needed to confirm this finding.
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Affiliation(s)
- Magdalena Żebrowska
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Carri Westgarth
- Department of Livestock and One Health, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Curtis Huttenhower
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Heather A. Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Shahab Haghayegh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Jaime Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Bernard Rosner
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Ichiro Kawachi
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Jorge E. Chavarro
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Olivia I. Okereke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Eva S. Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
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27
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Magnani L, Aguglia A, Alexander J, Maiorano A, Richard-Lepouriel H, Iancau SP, Amerio A, Parise A, Serafini G, Amore M, Nguyen KD, Costanza A. Evening Chronotype and Suicide: Exploring Neuroinflammation and Psychopathological Dimensions as Possible Bridging Factors-A Narrative Review. Brain Sci 2023; 14:30. [PMID: 38248245 PMCID: PMC10813318 DOI: 10.3390/brainsci14010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
A chronotype is generally defined as the variability of the phase angle of entrainment, while the latter reflects the relationship between the timing of a certain rhythm (e.g., the sleep-wake cycle) and the timing of an external temporal cue. Individuals can be placed on a spectrum from "morning types" (M types) to "evening types" (E types). E-chronotype has been proposed as a transdiagnostic risk factor for psychiatric conditions, and it has been associated with psychopathological dimensions. Eveningness seems to be correlated with both suicidal ideation (SI) and suicidal behavior (SB) through several possible mediating factors. Immunological alterations have also been linked to later chronotypes and SI/SB. This narrative review aims to summarize the evidence supporting the possible association between chronotypes and suicide and the eventual mediating role of neuroinflammation and several psychopathological dimensions. A search of the literature (2003-2023) was conducted using various databases: PUBMED, EMBASE, Scopus, UpToDate, PsycINFO, and Cochrane Library. English-language articles were collected and screened for eligibility. Despite the apparent absence of a direct correlation between E-chronotype and suicidality, E-chronotype promotes a chain of effects that could be involved in an increased risk of SB, in which with neuroinflammation possibly plays an intriguing role and some psychopathological dimensions may stand out.
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Affiliation(s)
- Luca Magnani
- Department of Psychiatry, San Maurizio Hospital, 39100 Bolzano, Italy;
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Jacques Alexander
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
| | - Alessandra Maiorano
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
| | - Hélène Richard-Lepouriel
- Department of Psychiatry, Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital (HUG), 1205 Geneva, Switzerland;
| | - Sidonia Paula Iancau
- Residence School in Psychiatry, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, 00185 Rome, Italy;
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Alberto Parise
- Geriatric-Rehabilitation Department, University Hospital of Parma, 43126 Parma, Italy;
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (G.S.); (M.A.)
- IRCCS Polyclinic Hospital San Martino, 16132 Genoa, Italy
| | - Khoa D. Nguyen
- Chinese University of Hong Kong, Hong Kong SAR, China;
- Tranquis Therapeutics, Palo Alto, CA 94303, USA
| | - Alessandra Costanza
- Department of Psychiatry, Geneva University Hospital (HUG), 1205 Geneva, Switzerland; (J.A.); (A.M.)
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), 6900 Lugano, Switzerland
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), 1205 Geneva, Switzerland
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28
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Zhang Y, Li S, Xie Y, Xiao W, Xu H, Jin Z, Li R, Wan Y, Tao F. Role of polygenic risk scores in the association between chronotype and health risk behaviors. BMC Psychiatry 2023; 23:955. [PMID: 38124075 PMCID: PMC10731716 DOI: 10.1186/s12888-023-05337-z] [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] [Received: 08/01/2023] [Accepted: 11/01/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND This study explores the association between chronotypes and adolescent health risk behaviors (HRBs) by testing how genetic background moderates these associations and clarifies the influence of chronotypes and polygenic risk score (PRS) on adolescent HRBs. METHODS Using VOS-viewer software to select the corresponding data, this study used knowledge domain mapping to identify and develop the research direction with respect to adolescent risk factor type. Next, DNA samples from 264 students were collected for low-depth whole-genome sequencing. The sequencing detected HRB risk loci, 49 single nucleotide polymorphisms based to significant SNP. Subsequently, PRSs were assessed and divided into low, moderate, and high genetic risk according to the tertiles and chronotypes and interaction models were constructed to evaluate the association of interaction effect and clustering of adolescent HRBs. The chronotypes and the association between CLOCK-PRS and HRBs were examined to explore the association between chronotypes and mental health and circadian CLOCK-PRS and HRBs. RESULTS Four prominent areas were displayed by clustering information fields in network and density visualization modes in VOS-viewer. The total score of evening chronotypes correlated with high-level clustering of HRBs in adolescents, co-occurrence, and mental health, and the difference was statistically significant. After controlling covariates, the results remained consistent. Three-way interactions between chronotype, age, and mental health were observed, and the differences were statistically significant. CLOCK-PRS was constructed to identify genetic susceptibility to the clustering of HRBs. The interaction of evening chronotypes and high genetic risk CLOCK-PRS was positively correlated with high-level clustering of HRBs and HRB co-occurrence in adolescents, and the difference was statistically significant. The interaction between the sub-dimensions of evening chronotypes and the high genetic CLOCK-PRS risk correlated with the outcome of the clustering of HRBs and HRB co-occurrence. CONCLUSIONS The interaction of PRS and chronotype and the HRBs in adolescents appear to have an association, and the three-way interaction between the CLOCK-PRS, chronotype, and mental health plays important roles for HRBs in adolescents.
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Affiliation(s)
- Yi Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Wan Xiao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China.
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, 230032, Hefei, Anhui, China.
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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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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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Kim SY, Kim HJ, Cho SS, Park MY, Kang MY. Mediation analysis of chronotype, sleep-related factors, and depressive symptoms among workers: a cross-sectional study. Ann Occup Environ Med 2023; 35:e47. [PMID: 38148918 PMCID: PMC10751214 DOI: 10.35371/aoem.2023.35.e47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/07/2023] [Accepted: 10/30/2023] [Indexed: 12/28/2023] Open
Abstract
Background This study aimed to examine the impact of chronotype on depressive symptoms and explore the mediating effects of sleep quality, pre-sleep cognitive arousal, and social jetlag in a sample of wage earners. Methods A total of 3,917 waged workers were surveyed online in July 2022. Logistic regression and mediation analysis were used to assess the relationship between chronotype (morningness, intermediate, and eveningness) and depressive symptoms (Patient Health Questionnaire ≥ 5), and the mediating effects of Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Pre-Sleep Arousal Scale (PSAS). All analyses were adjusted for age, education level, income level, marital status, coffee consumption, alcohol consumption, physical activity, occupation, employment status, and working hours to calculate odds ratios (ORs). Results The chronotypes of all the participants were divided into morningness (4.7%), intermediate (93.5%), and eveningness (1.8%). Multiple logistic regression analysis showed an increased risk of depression in the eveningness chronotype (OR: 2.96; 95% confidence interval [CI]: 1.51, 5.86). Regarding the mediation analysis, ISI mediated 28.44% (95% CI: 16.39-40.5), PSQI for 31.25% (95% CI: 19.36, 43.15), and PSAS-Cognitive Score (PSAS-C) for 23.58% (95% CI: 10.66, 36.50) of the association between chronotype and depressive symptoms. However, social jetlag did not significantly mediate this relationship. (percentage mediated = 0.75%, 95% CI: -3.88, 5.39). Conclusions Evening chronotypes exhibit an increased risk of depressive symptoms, which ISI, PSQI, and PSAS-C partially mediated. This suggests that interventions to improve sleep quality and maintain adequate sleep habits may effectively prevent and treat depression in employees with an eveningness chronotype.
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Affiliation(s)
- Seo Young Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyo Jeong Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong-Sik Cho
- Department of Occupational and Environmental Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Min Young Park
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Sirtoli R, Mata GDG, Rodrigues R, Martinez-Vizcaíno V, López-Gil JF, Guidoni CM, Mesas AE. Is evening chronotype associated with higher alcohol consumption? A systematic review and meta-analysis. Chronobiol Int 2023; 40:1467-1479. [PMID: 37974373 DOI: 10.1080/07420528.2023.2256899] [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: 02/15/2023] [Accepted: 09/02/2023] [Indexed: 11/19/2023]
Abstract
A broader understanding of whether and to what extent chronotype should be considered a risk factor for alcohol consumption is needed. The aim of this systematic review was to summarize the evidence on the association between evening chronotype and alcohol consumption. A systematic search of observational studies on this association was conducted in the PubMed, Scopus, Web of Science, Cochrane Library and PsycINFO databases up to April 30th, 2023. Random-effect models estimated the pooled odds ratio (OR) of alcohol consumption according to chronotype. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Quality Assessment tool for Observational Cohorts and Cross-sectional Studies from the National Heart, Lung and Blood Institute were followed. A total of 33 studies involving 28 207 individuals (age range: 18-93 years) were included in this review. Overall, most studies indicated a higher volume and frequency of alcohol consumption in evening-type individuals than in individuals with different chronotypes. Additionally, a meta-analysis including 13 studies showed that evening-type individuals were 41% more likely to consume alcohol than those with other chronotypes (OR = 1.41, 95% confidence interval: 1.16-1.66; I2 = 38.0%). Limitations of the present findings are the predominance of cross-sectional studies and varied definitions of alcohol consumption. The available evidence supports an association between the evening chronotype and alcohol consumption. The evening-type population, especially young adults, is a specific target for educational interventions for preventing or reducing alcohol consumption.PROSPERO number: CRD42022343778.
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Affiliation(s)
- Rafaela Sirtoli
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - Renne Rodrigues
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
- Department of Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Vicente Martinez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - José Francisco López-Gil
- Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra, IdiSNA, Pamplona, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Camilo Molino Guidoni
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
- Department of Pharmaceutical Sciences, Universidade Estadual de Londrina, Londrina, Brazil
| | - Arthur Eumann Mesas
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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Rofe N, Brosh YS, Vardi-Naim H, Einat H, Kronfeld-Schor N, Lan A. Salivary cortisol concentration and perceived stress measure in response to acute natural stress: The role of morningness-eveningness preference. Chronobiol Int 2023; 40:1515-1521. [PMID: 37919934 DOI: 10.1080/07420528.2023.2276203] [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: 06/14/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
Chronotype reflects the morningness-eveningness preference over a 24-h period. Significant data indicates meaningful differences between evening types (ET) and morning types (MT) in behavior, personality traits, health and well-being. The aim of this study was to investigate cortisol response and subjective perceived stress of MT and ET individuals in response to an acute natural stressor. Twenty six definite MT (mean age 23.4 ± 1.7) and twenty six definite ET (mean age 23.8 ± 1.3) college students were recruited for this study. Participants were instructed to evaluate their perceived subjective stress and to provide saliva samples for cortisol levels at four different time points: Morning of regular school day, morning immediately before a final exam, afternoon of a regular school day and afternoon immediately before a final exam. For general mood assessment, the participants were also asked to fill out the Positive and Negative Affect Schedule (PANAS) questionnaire. The most outstanding finding of this study was the blunting of cortisol increase in response to acute stress in the morning in the ET group: Salivary cortisol was higher before a final exam only in MT but not in ET. However, no differences between the groups were found in the subjective stress measure. In the PANAS scale, ET showed lower positive affect, and a trend towards a higher negative affect. Overall, our results suggest dysregulation of cortisol response in ET individuals, possibly due to their daily struggle to function in a morning-oriented society. These results further highlight the challenges faced by ET individuals and raise the question of possible interventions to assist them.
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Affiliation(s)
- Noa Rofe
- School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | - Yuval S Brosh
- School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | | | - Haim Einat
- School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel
| | | | - Anat Lan
- School of Behavioral Sciences, Tel-Aviv-Yaffo Academic College, Tel-Aviv, Israel
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Coelho J, Lucas G, Micoulaud-Franchi JA, Tran B, Yon DK, Taillard J, D'Incau E, Philip P, Boyer L, Fond G. Sleep timing, workplace well-being and mental health in healthcare workers. Sleep Med 2023; 111:123-132. [PMID: 37769583 DOI: 10.1016/j.sleep.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Healthcare workers face an elevated risk of burnout, sleep disorders, and mental health issues, potentially stemming from the misalignment of their circadian rhythm due to nonstandard work schedules. This cross-sectional survey aims to examine the connections between sleep timing, workplace well-being (including burnout and absenteeism), and mental health outcomes (specifically depression and poor sleep) in healthcare workers. Additionally, the survey takes into account individual and professional factors, as well as the interaction with work schedules. METHODS The study encompasses 4,971 healthcare workers from both public and private healthcare facilities in France, including nurses, nursing assistants, and physicians recruited during the third wave of the COVID-19 pandemic. The Maslach Burnout Inventory assesses burnout, the Center for Epidemiologic Studies Depression Scale measures depression, and the Pittsburgh Sleep Quality Index evaluates poor sleep. Sleep timing is categorized into morning, neutral, and evening timing, referred to as midsleep. Multivariate logistic regression analysis is conducted to explore the relationships between sleep timing and burnout, depression, and poor sleep, while adjusting for various factors. RESULTS The findings reveal that 56.5% of participants experience burnout, 29.8% report depression, and 64.5% report poor sleep. Nurses and nursing assistants exhibit a higher prevalence of poor sleep. Morning sleep timing is associated with burnout among those with fixed schedules and with depression among those with shift schedules. Among physicians, both morning and evening sleep timing are associated with depression, while morning sleep timing is linked to poor sleep across all subgroups. INTERPRETATION This study suggests that the misalignment between healthcare workers' internal circadian rhythm and their work schedules may contribute to an increased risk of burnout, depression, and poor sleep. Occupational health services and policymakers should recognize the potential for enhancing workplace well-being and mental health outcomes by enabling healthcare workers to maintain sleep schedules that accommodate their needs.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Bach Tran
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jacques Taillard
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France
| | - Emmanuel D'Incau
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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Mun CJ, Winsick N, Wegener ST, Youngstedt SD, Campbell CM, Aaron RV. Medium- and Long-Term Effects of Insomnia Severity and Circadian Preference on Pain and Emotional Distress Among Individuals With Chronic Pain. THE JOURNAL OF PAIN 2023; 24:1946-1956. [PMID: 37286095 PMCID: PMC10615674 DOI: 10.1016/j.jpain.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/21/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
Studies have identified insomnia as having significant influence on chronic pain. A rising body of research has also underscored the association between eveningness and chronic pain. However, co-assessment of insomnia and eveningness in the context of chronic pain adjustment has been limited. The present study sought to investigate the effects of insomnia and eveningness on pain severity, pain interference, and emotional distress (ie, depressive and anxiety symptoms) over nearly 2 years among adults with chronic pain in the U.S. Adults with chronic pain (N = 884) were surveyed 3 times via Amazon's MTurk online crowdsourcing platform: baseline, 9-month follow-up, and 21-month follow-up. Path analysis was conducted to examine the effects of baseline insomnia severity (Insomnia Severity Index) and eveningness (Morningness and Eveningness Questionnaire), as well as their moderating effects on outcomes. Controlling for select sociodemographic variables and baseline outcome levels, greater insomnia severity at baseline was associated with worsening of all of the pain-related outcomes at 9-month follow-up, and pain interreference and emotional distress at 21-month follow-up. We did not find evidence that evening types are at a higher risk of experiencing worsening pain-related outcomes over time compared to morning and intermediate types. There were also no significant insomnia severity and eveningness moderation effects on any outcome. Our findings suggest that insomnia is a more robust predictor of changes in pain-related outcomes as compared to eveningness. Treatment of insomnia can be important in chronic pain management. Future studies should evaluate the role of circadian misalignment on pain using more accurate biobehavioral makers. PERSPECTIVE: This study examined the effects of insomnia and eveningness on pain and emotional distress in a large sample of individuals with chronic pain. Insomnia severity is a stronger predictor of changes in pain and emotional distress than eveningness, highlighting insomnia as an important clinical target for chronic pain management.
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Affiliation(s)
- Chung Jung Mun
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Nina Winsick
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD
| | - Shawn D Youngstedt
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Rachel V Aaron
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD
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Colelli DR, Dela Cruz GR, Kendzerska T, Murray BJ, Boulos MI. Impact of sleep chronotype on in-laboratory polysomnography parameters. J Sleep Res 2023; 32:e13922. [PMID: 37150591 DOI: 10.1111/jsr.13922] [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: 10/26/2022] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 05/09/2023]
Abstract
Morningness-eveningness preference, also known as chronotype, is the tendency for a person to sleep during certain hours of the day and is broadly categorised into morning and evening types. In-laboratory polysomnography (iPSG) is the gold-standard to assess sleep, however, an individual's chronotype is not accounted for in current protocols, which may confound collected sleep data. The objective of our study was to assess if chronotype had an association with sleep physiology. Patients who completed the diagnostic iPSG and the Morningness-Eveningness Questionnaire (MEQ), which categorises patients into morning type, neither or evening type, were assessed. Multivariable linear regression models were used to assess if chronotype was associated with sleep quality, duration, and physiology during iPSG. The study sample included 2612 patients (mean age of 53.6 years, 48% male) recruited during 2010-2015. Morning type, compared with neither type, was significantly associated with an increase in total sleep time and rapid eye movement (REM) sleep, and a decrease in sleep onset latency and the arousal index. Evening type, compared with neither type, was significantly associated with a decrease in total sleep time, sleep efficiency, and REM sleep, and an increase in sleep onset latency and wake after sleep onset. Additionally, iPSG lights out time was significantly different between the different chronotypes. Overall, a morningness chronotype was associated with favourable sleep quality and duration while an eveningness chronotype was associated with reduced sleep quality. Our study quantifies the association of chronotype with iPSG metrics and suggests that laboratory protocols should consider chronotype in their evaluations.
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Affiliation(s)
- David R Colelli
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Gio R Dela Cruz
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Tetyana Kendzerska
- The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Brian J Murray
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Sleep Laboratory, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark I Boulos
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
- Sleep Laboratory, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Grady CL, Rieck JR, Baracchini G, DeSouza B. Relation of resting brain signal variability to cognitive and socioemotional measures in an adult lifespan sample. Soc Cogn Affect Neurosci 2023; 18:nsad044. [PMID: 37698268 PMCID: PMC10508322 DOI: 10.1093/scan/nsad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 07/09/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
Temporal variability of the fMRI-derived blood-oxygen-level-dependent (BOLD) signal during cognitive tasks shows important associations with individual differences in age and performance. Less is known about relations between spontaneous BOLD variability measured at rest and relatively stable cognitive measures, such as IQ or socioemotional function. Here, we examined associations among resting BOLD variability, cognitive/socioemotional scores from the NIH Toolbox and optimal time of day for alertness (chronotype) in a sample of 157 adults from 20 to 86 years of age. To investigate individual differences in these associations independently of age, we regressed age out from both behavioral and BOLD variability scores. We hypothesized that greater BOLD variability would be related to higher fluid cognition scores, more positive scores on socioemotional scales and a morningness chronotype. Consistent with this idea, we found positive correlations between resting BOLD variability, positive socioemotional scores (e.g. self-efficacy) and morning chronotype, as well as negative correlations between variability and negative emotional scores (e.g. loneliness). Unexpectedly, we found negative correlations between BOLD variability and fluid cognition. These results suggest that greater resting brain signal variability facilitates optimal socioemotional function and characterizes those with morning-type circadian rhythms, but individuals with greater fluid cognition may be more likely to show less temporal variability in spontaneous measures of BOLD activity.
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Affiliation(s)
- Cheryl L Grady
- Rotman Research Institute at Baycrest, Toronto, Ontario M6A 2E1, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, Ontario M5S 3G3, Canada
| | - Jenny R Rieck
- Rotman Research Institute at Baycrest, Toronto, Ontario M6A 2E1, Canada
| | - Giulia Baracchini
- Department of Neurology and Neurosurgery, Montréal Neurological Institute, McGill University, Montréal, Quebec H3A 0G4, Canada
| | - Brennan DeSouza
- Rotman Research Institute at Baycrest, Toronto, Ontario M6A 2E1, Canada
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Yang HJ, Cheng WJ, Hsiao MC, Huang SC, Kubo T, Hang LW, Lee WS. Rest-activity rhythm associated with depressive symptom severity and attention among patients with major depressive disorder: a 12-month follow-up study. Front Psychiatry 2023; 14:1214143. [PMID: 37663595 PMCID: PMC10469591 DOI: 10.3389/fpsyt.2023.1214143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Patients with depressive disorder demonstrate rest-activity rhythm disturbances and cognitive function impairment. This study examined the association of individual rest-activity rhythm changes over time with mood symptoms and attention. Methods We recruited 15 adult outpatients with a diagnosis of major depressive disorder from a single medical center and observed them for 12 months. Weekly rest-activity parameters, including rhythm characteristics generated from nonparametric circadian rhythm analysis, were retrieved from actigraphy data. Attention was evaluated weekly with a smartphone-based psychomotor vigilance test upon awakening. Depressive symptom severity was evaluated using the Beck Depression Inventory (BDI) fortnightly. The association of rest-activity parameters with BDI score and attention was examined using generalized linear mixed regression. A fixed-effects analysis was used to examine the association between rest-activity parameters and depressive episodes. Results An advanced bedtime and most active continuous 10 h starting time were associated with depressive symptom severity but also associated with higher vigilance test performance. A longer sleep duration, mainly due to an earlier bedtime, was associated with depressive symptom severity. Compared to remission, sleep duration was 27.8 min longer during depressive episodes, and bed time was 24 min earlier. A shorter sleep duration and increased activity during sleep were associated with poorer attention. Discussion Rest-activity rhythms change with mood symptoms among patients with depressive disorder. The circadian rhythms of rest-activity among patients with depressive disorder should be distinguished during various mood states in future studies.
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Affiliation(s)
- Hang-Ju Yang
- Department of Emergency Medicine, Jen Ai Hospital Dali Branch, Taichung, Taiwan
| | - Wan-Ju Cheng
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
| | - Mi-Chun Hsiao
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Sheng-Che Huang
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Tomohide Kubo
- National Institute of Occupational Safety and Health, Kawasaki, Japan
| | - Liang-Wen Hang
- Department of Pulmonary and Critical Care Medicine, Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
| | - Wei-Sheng Lee
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
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Lotti S, Dinu M, Colombini B, Amedei A, Sofi F. Circadian rhythms, gut microbiota, and diet: Possible implications for health. Nutr Metab Cardiovasc Dis 2023; 33:1490-1500. [PMID: 37246076 DOI: 10.1016/j.numecd.2023.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/30/2023]
Abstract
AIMS Over the past years, interest in chrono-nutrition has grown enormously as the fundamental role of circadian rhythms in regulating most physiological and metabolic processes has become clearer. Recently, the influence of circadian rhythms on the gut microbiota (GM) composition has also emerged, as more than half of the total microbial composition fluctuates rhythmically throughout the day. At the same time, other studies have observed that the GM itself synchronises the host's circadian biological clock through signals of a different nature. Therefore, it has been hypothesised that there is a two-way communication between the circadian rhythms of the host and the GM, but researchers have only just begun to identify some of its action mechanisms. The manuscript aim is, therefore, to gather and combine the latest evidence in the field of chrono-nutrition with the more recent research on the GM, in order to investigate their relationship and their potential impact on human health. DATA SYNTHESIS Considering current evidence, a desynchronization of circadian rhythms is closely associated with an alteration in the abundance and functionality of the gut microbiota with consequent deleterious effects on health, such as increased risk of numerous pathologies, including cardiovascular disease, cancer, irritable bowel disease, and depression. A key role in maintaining the balance between circadian rhythms and GM seems to be attributed to meal-timing and diet quality, as well as to certain microbial metabolites, in particular short-chain fatty acids. CONCLUSIONS Future studies are needed to decipher the link between the circadian rhythms and specific microbial patterns in relation to different disease frameworks.
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Affiliation(s)
- Sofia Lotti
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Italy.
| | - Barbara Colombini
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Unit of Clinical Nutrition, Careggi University Hospital, Florence, Italy.
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Harris E, Carciofo R. The association between eveningness and autistic traits: Mediating effects of depression and insomnia. Chronobiol Int 2023; 40:961-969. [PMID: 37334796 DOI: 10.1080/07420528.2023.2224872] [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: 03/01/2023] [Revised: 05/09/2023] [Accepted: 06/08/2023] [Indexed: 06/21/2023]
Abstract
There is a lack of research on the relationships between autistic traits and morningness-eveningness. The current research explored associations between autistic traits (preferences for routine, difficulties with imagination, difficulties with social skills, fixations with numbers and patterns, and difficulties with attention switching) and morningness-eveningness, including the component of Morning Affect (alertness/energy upon awakening). The potential mediation effects of depression and insomnia were also tested. 163 adults (university students and general population) completed an online survey including questionnaire measures of autistic traits, morningness-eveningness, depression, and insomnia. Positive correlations were found between most autistic trait subcomponents, depression, and insomnia. The autistic trait of difficulties in attention switching was correlated with more eveningness and with less Morning Affect, but significant correlations were not observed with any other autistic trait. Depression mediated the relationship between eveningness and difficulties in attention switching. Although insomnia alone was not a significant mediator, when combined with depression in a serial mediator model, a significant mediation effect was shown. The current results suggest that greater eveningness may be related with the autistic trait of difficulties in attention switching possibly through the mechanism of increased insomnia and elevated risk for depression. These findings may potentially inform interventions.
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Affiliation(s)
- Ellie Harris
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Richard Carciofo
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Bem-Haja P, Silva A, Rosa C, Queiroz DF, Barroso T, Cerri L, Alves MF, Silva CF, Santos IM. Chronotype and Time of Day Effects on a Famous Face Recognition Task with Dynamic Stimuli. Int J Psychol Res (Medellin) 2023; 16:51-61. [PMID: 38106959 PMCID: PMC10723745 DOI: 10.21500/20112084.6583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 06/07/2023] [Accepted: 07/25/2023] [Indexed: 12/19/2023] Open
Abstract
Chronotype and Time of Day (ToD) can modulate several aspects of cognitive performance. However, there is limited evidence about the effect of these variables on face recognition performance, so the aim of the present study is to investigate this influence. For this, 274 participants (82.5% females; age 18-49 years old, mean = 27.2, SD = 1.82) were shown 20 short videoclips, each gradually morphing from a general identity unfamiliar face to a famous face. Participants should press the spacebar to stop each video as soon as they could identify the famous face, and then provide the name or an unequivocal description of the person. Analysis of response times (RT) showed that evening-types recognised the faces faster than morning-types. Considering different ToD windows, the effect of chronotype was only significant in the 13h-17h and in the 21h-6h time-windows. Altogether, results suggest an advantage of evening-types on famous face recognition using dynamic stimuli with morning-types, being particularly slower during their non-optimal period.
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Affiliation(s)
- Pedro Bem-Haja
- CINTESIS@RISE, University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - André Silva
- University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Catarina Rosa
- CINTESIS@RISE, University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Diâner F. Queiroz
- University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Talles Barroso
- University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Luíza Cerri
- University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Miguel F. Alves
- University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Carlos F. Silva
- William James Center for Research, University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
| | - Isabel M. Santos
- William James Center for Research, University of Aveiro, 3810-193 Aveiro, Portugal.Universidade de AveiroUniversity of AveiroAveiroPortugal
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Zhang Y, Jin Z, Li S, Xu H, Wan Y, Tao F. Relationship between chronotype and mental behavioural health among adolescents: a cross-sectional study based on the social ecological system. BMC Psychiatry 2023; 23:404. [PMID: 37280607 DOI: 10.1186/s12888-023-04879-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Health risk behaviors (HRBs) is a kind of phenomenon behavior that often occurs in adolescence, and also often appears in clusters. Previous studies suggested an association between social ecological risk factors (SERFs) and HRBs. This study explored 1) whether chronotype moderates the risk of HRBs associated with SERFs and 2) whether mental health is a mediator in this relationship. METHODS Adolescents were recruited from 39 junior or senior schools (three cities, 13 schools per city) using a multistage cluster sampling method conducted between October, 2020 and June, 2021. The Social Ecological System, Morningness-Eveningness Questionnaire, Brief Instrument on Psychological Health Youths, and Youth Risk Behavior Surveillance questionnaires were used to measure the SERFs, chronotype, mental health and HRBs. Latent category analysis was used to explore the clustering mode of HRBs. The primary exposure was SERFs, and the primary outcome was HRBs; chronotype was a moderator, and mental health was a mediator. The multivariable logistic regression model was used to determine the relationship between SERFs and chronotype and mental behavioral health status. Mediation moderate analysis using the PROCESS method was used to explore the relationship between these variables. Sensitivity analysis was conducted to evaluate the robustness of the model. RESULTS In total, 17,800 individuals were initially enrolled. After excluding 947 individuals with invalid questionnaires, 16,853 participants were finally included in the analysis. The mean age of participants was 15.33 ± 1.08 years. After adjusting for covariates, multivariable logistic regression found that high levels of SERFs (odds ratio [OR] = 10.10, 95% confidence interval [CI]: 8.88-11.43, P < 0.01), intermediate chronotype (OR = 5.24, 95% CI: 4.57-6.01, P < 0.01), and eveningness (OR = 1.83, 95% CI: 1.64-2.05, P < 0.01) were associated with higher HRBs frequency. This study also assessed the interaction between chronotype, SERFs and HRBs (OR = 27.84, 95% CI: 22.03-35.19, P < 0.01) and mental health (OR = 18.46, 95% CI: 13.16-25.88, P < 0.01). The moderated mediation analyses examined the relationship between chronotype, SERFs, mental health and HRBs. CONCLUSIONS SERFs may be important variables in measuring the effect of the adolescent psychosocial environment on HRBs; this effect is mediated by mental health and moderated by chronotype.
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Affiliation(s)
- Yi Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- NHC Key Laboratory of Study On Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- MOE Key Laboratory of Population Health Across Life Cycle, No 81 Meishan Road, Hefei, 230032, Anhui, China.
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Wong TR, Hickie IB, Carpenter JS, Scott EM, Guastella AJ, Vidafar P, Scott J, Hermens DF, Crouse JJ. Dynamic modelling of chronotype and hypo/manic and depressive symptoms in young people with emerging mental disorders. Chronobiol Int 2023; 40:699-709. [PMID: 37132360 DOI: 10.1080/07420528.2023.2203241] [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: 10/17/2022] [Revised: 02/21/2023] [Accepted: 04/11/2023] [Indexed: 05/04/2023]
Abstract
There is significant interest in the possible influence of chronotype on clinical states in young people with emerging mental disorders. We apply a dynamic approach (bivariate latent change score modelling) to examine the possible prospective influence of chronotype on depressive and hypo/manic symptoms in a youth cohort with predominantly depressive, bipolar, and psychotic disorders (N = 118; 14-30-years), who completed a baseline and follow-up assessment of these constructs (mean interval = 1.8-years). Our primary hypotheses were that greater baseline eveningness would predict increases in depressive but not hypo/manic symptoms. We found moderate to strong autoregressive effects for chronotype (β = -0.447 to -0.448, p < 0.001), depressive (β = -0.650, p < 0.001) and hypo/manic symptoms (β = -0.819, p < 0.001). Against our predictions, baseline chronotypes did not predict change in depressive (β = -0.016, p = 0.810) or hypo/manic symptoms (β = 0.077, p = 0.104). Similarly, the change in chronotype did not correlate with the change in depressive symptoms (β = -0.096, p = 0.295) nor did the change in chronotype and the change in hypo/manic symptoms (β = -0.166, p = 0.070). These data suggest that chronotypes may have low utility for predicting future hypo/manic and depressive symptoms in the short term, or that more frequent assessments over longer periods are needed to observe these associations. Future studies should test whether other circadian phenotypes (e.g. sleep-wake variability) are better indicators of illness course.
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Affiliation(s)
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Australia
| | | | | | | | | | - Jan Scott
- Brain and Mind Centre, University of Sydney, Australia
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, UK
- Université de Paris, Paris, France
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Li B, Liao G, Lee PMY, Huss A, Ma YTJ, Chan JWY, Wing YK, Tse LA. Association between matched chronotype and poor mental health among shift workers: a systematic review and meta-analysis. J Epidemiol Community Health 2023:jech-2022-220280. [PMID: 37258217 DOI: 10.1136/jech-2022-220280] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Nearly 0.7 billion workers are involved in the shift work system, leading to concerns about its potential impacts on the large-scale population mental health. This study aimed to synthesise evidence of the associations between matched chronotype and the risk of poor mental health among shift workers. METHODS Six computerised databases were searched from inception to September 2022. Observational studies were selected if they reported any association between common mental health parameters and chronotype scores/types of shift workers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist was followed. We extracted adjusted risk estimates to calculate pooled effect sizes and explore sources of heterogeneity. The study was registered in PROSPERO: CRD42022357437. RESULTS Fourteen studies including 49 909 workers were identified. Ever shift workers had a higher risk of poor mental health than the day workers (pooled OR 1.15, 95% CI 1.03 to 1.28; I2=14%, p=0.29), with the evening chronotype ever shift workers having a 1.47 times higher risk than those who worked during the day (pooled OR 1.47, 95% CI 1.13 to 1.91; I2=42%, p=0.16). Sensitivity analysis excluding studies with the highest risk of bias of each group demonstrated consistent findings. CONCLUSIONS Evening chronotype ever shift workers have poorer mental health than shift workers with other chronotypes. Chronotype remains unrecognised in the contemporary rostering system, making it a hidden contributor to occupational mental health. Work-related physical and mental stresses may be prevented/mitigated with further investigation on optimising shift work schedule combined with individual chronotype preference.
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Affiliation(s)
- Beixi Li
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Gengze Liao
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Priscilla Ming Yi Lee
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
- Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus Universitet, Aarhus, Denmark
| | - Anke Huss
- Department of Population Health Sciences, Utrecht University, Utrecht, Netherlands
| | - Yuen Ting Julie Ma
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Joey Wing-Yan Chan
- Department of Psychiatry, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Yun Kwok Wing
- Department of Psychiatry, The Chinese University, Hong Kong SAR, People's Republic of China
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, The Chinese University, Hong Kong SAR, People's Republic of China
- Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, People's Republic of China
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Wang S, Wang H, Deng X, Lei X. Validation of the Munich Chronotype Questionnaire (MCTQ) in Chinese college freshmen based on questionnaires and actigraphy. Chronobiol Int 2023:1-12. [PMID: 37080772 DOI: 10.1080/07420528.2023.2202246] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
The Munich Chronotype Questionnaire (MCTQ) was developed to determine an individual's chronotype, and it provides information about sleep and wake times separately for work and free days. However, the MCTQ has not been effectively verified using a large sample based on multiple questionnaires and actigraphy measures. Three sequential studies were conducted. Study 1 used a large sample (n = 1066) to investigate the chronotype of Chinese college freshmen and assess the validity of the MCTQ compared with the reduced Morningness-Eveningness Questionnaire (rMEQ), actigraphy, and other related questionnaires. Study 2 verified the MCTQ compared with a sleep diary. Study 3 examined the test-retest reliability of the MCTQ at the 2-year follow-up. The results showed that MCTQ parameters were significantly associated with rMEQ scores, the actigraphy-based mid-point of sleep, sleep quality, depression, and trait anxiety. In addition, all MCTQ variables were significantly related to the diary-based sleep mid-point. The test-retest reliability of the mid-point of sleep adjusted for sleep debt (MSFsc) and mid-point of sleep on free days (MSF) was acceptable. These results indicate that the MCTQ is a practical and efficient tool with good reliability. Its further development is important for the accurate assessment of chronotypes and clinical diagnoses of sleep.
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Affiliation(s)
- Shuo Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Haien Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
| | - Xinyi Deng
- Department of Psychology, Cornell University, Ithaca, New York, USA
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
- Key Laboratory of Cognition and Personality (Southwest University), Ministry of Education, Chongqing, China
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Comas M, Solis Flores A, Lovato N, Miller CB, Bartlett DJ, Grunstein RR, Chapman J, Gordon CJ. The Relationship between Anxiety, Subjective and Objective Sleep, Chronotype and Circadian Rhythms with Depressive Symptoms in Insomnia Disorder. Brain Sci 2023; 13:brainsci13040613. [PMID: 37190578 DOI: 10.3390/brainsci13040613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Insomnia is a highly prevalent sleep disorder with strong bidirectional associations with depressive symptoms. The circadian preference for eveningness has been shown to be associated with depressive symptoms in insomnia and other mental health conditions. However, there is a lack of studies in insomnia investigating whether objective measures, such as dim light melatonin onset (DLMO) or polysomnographic (PSG) sleep, are associated with depressive symptoms. Therefore, we investigated the associations between subjective measures (questionnaires assessing anxiety, sleep quality and circadian preference, and sleep diary) and depressive symptoms and whether the addition of objective measures (DLMO, PSG parameters) would strengthen the associations with depressive symptoms. In 115 insomnia disorder patients we found that anxiety was strongly associated with depressive symptoms in a model including circadian preference, dysfunctional beliefs of sleep, and self-reported previous depressive symptoms (R2 = 0.496, p < 0.001). The addition of sleep diary measures did not strengthen the model. We also found that the addition of objective measures (DLMO, PSG parameters) did not improve the subjective associations with depressive symptoms. Our data suggest that objective circadian markers are less important in the prediction of depressive symptoms in insomnia compared to subjective measures.
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Affiliation(s)
- Maria Comas
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
- Renal Division, Department of Medicine, Faculty of Medicine and Medical Center, University of Freiburg, 79106 Freiburg, Germany
| | - Alejandra Solis Flores
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
| | - Nicole Lovato
- Flinders Health and Medical Research Institute Sleep Health (Formally Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence), College of Medicine and Public Health, Flinders University of South Australia, Sturt Rd., Bedford Park, Adelaide, SA 5042, Australia
| | - Christopher B Miller
- Big Health Inc., 461 Bush St. #200, San Francisco, CA 94108, USA
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Level 6, West Wing, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
| | - Delwyn J Bartlett
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
- CRC for Alertness, Safety and Productivity, Melbourne, VIC 3800, Australia
- Collaborative Centre for Cardiometabolic Health in Psychoses, Charles Perkins Centre-Royal Prince Alfred Hospital, Johns Hopkins Dr, Camperdown NSW 2006, Sydney Local Health District, Sydney, NSW 2050, Australia
| | - Julia Chapman
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, Sydney, NSW 2037, Australia
- Faculty of Medicine and Health, The University of Sydney, Science Rd., Camperdown, NSW 2050, Australia
- CRC for Alertness, Safety and Productivity, Melbourne, VIC 3800, Australia
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Yuan L, Lu L, Wang X, Qu M, Gao Y, Pan B. Comorbid anxiety and depressive symptoms and the related factors among international medical students in China during COVID-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:165. [PMID: 36918819 PMCID: PMC10014140 DOI: 10.1186/s12888-023-04638-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The two most prevalent mental health conditions are anxiety and depression and they often coexist (comorbidity) in an individual aggravating the person's psychological or medical conditions. College students suffered from anxiety and depressive symptoms during the COVID-19 pandemic, according to numerous studies. The lack of information on the comorbidity of anxiety and depression (CAD) among international medical students, however, makes it difficult to develop effective policies or strategies to support these students. OBJECTIVE The present research seeks to investigate the incidence of CAD among international medical students in China and to identify the variables that may be useful in predicting CAD. METHOD A cross-sectional study was conducted at China Medical University in Shenyang, China, for international medical students during November 2020. A total of 519 international students provided information on their demographics, stress related to the COVID-19 pandemic, generalized anxiety disorder assessment (GAD-7), patient health questionnaire-9 (PHQ-9), simplified coping style questionnaire (SCSQ), perceived stress scale (PSS-10), the multidimensional scale of perceived social support (MSPSS), revised life orientation test (LOT-R), and resilience scale-14 (RS-14). To investigate the potential predictors of CAD, a chi-square test, a nonparametric test, and multinomial logistic regression analyses were carried out as appropriate. RESULTS The incidence of anxiety, depression, and CAD in the current study was 5.8%, 8.9%, and 22.7%, respectively. The predictors for students having symptoms of anxiety were observed to be the negative coping style (β = 0.662, OR = 1.938, CI:1.07-3.694) and perceived stress (β = 0.167, OR = 1.181, CI:1.076-1.297); the predictors for students having symptoms of depression were observed to be the COVID-19 pandemic-related stress (β = 0.323,OR = 1.382,CI:1.211-1.577), negative coping style (β = 0.693,OR = 2.000, CI:1.21-3.568), and perceived stress (β = 0.135,OR = 1.145,CI:1.050-1.248); whereas the predictors for students with CAD were observed to be staying up late (Yes VS No) (β = 1.028,OR = 2.794,CI:1.227-6.364), current place of residence (Other continents VS China) (β = -1.413, OR = 0.243,CI:0.065-0.910), COVID-19 pandemic-related stress (β = 0.371,OR = 1.450,CI:1.284-1.636), negative coping style (β = 1.092,OR = 2.979,CI:1.706-5.203), and perceived stress (β = 0.339,OR = 1.403,CI:1.289-1.527). CONCLUSION Single anxiety and depressive symptoms were moderately prevalent among international medical students in China. However, CAD turned out to be the most prevalent mental health issue due to its relatively higher incidence. Negative coping style and perceived stress were the communal predictors of the three categories, whereas stress related to the COVID-19 pandemic was linked to both depression and CAD, and staying up late and in residential places were specific predictors for CAD. Study results suggest that COVID-19 pandemic-related stress was related to students' CAD and depressive symptoms, and specific intervention measures with stress reduction, proper coping strategy, and a good lifestyle might be useful in improving the international students' mental health status.
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Affiliation(s)
- Lulu Yuan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Lu Lu
- China Medical University-The Queen's University of Belfast Joint College, China Medical University, Shenyang, China
| | - Xuehang Wang
- International Education School, China Medical University, Shenyang, China
| | - Min Qu
- International Education School, China Medical University, Shenyang, China
| | - Yuqin Gao
- School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Bochen Pan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
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48
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Carciofo R. Morning affect or sleep inertia? Comparing the constructs and their measurement. Chronobiol Int 2023:1-15. [PMID: 36912023 DOI: 10.1080/07420528.2023.2187211] [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: 03/14/2023]
Abstract
The construct of Morning Affect (MA; alertness upon awakening/time required to feel fully awake) emerged from exploratory factor analysis of morningness-eveningness questionnaires, and while it has been equated with morningness-eveningness preference it has much conceptual overlap with sleep inertia (SI; the transitional state between sleep and being fully awake). The current study compared questionnaire measures of these constructs to help clarify their inter-relationships. A volunteer sample of 453 students at an English-medium university in China completed an online survey including the Sleep Inertia Questionnaire (SIQ), the Morningness-Eveningness-Stability-Scale-improved (MESSi), with subscales for MA, Eveningness, and Distinctness (amplitude of diurnal variation), and the reduced Morningness-Eveningness Questionnaire (rMEQ). Measures of depression, sleep quality, mindfulness, and personality were also included. Exploratory factor analysis of the SIQ, MESSi, and rMEQ items revealed seven factors: Cognitive, Emotional, and Physiological SI, Responses to SI (including one MA item), and Duration of SI (one SIQ item, 3/5 MA items, and one rMEQ item); Morningness-Eveningness (MESSi Eveningness items, plus 3/5 rMEQ items); Distinctness (3/5 MESSi items). These results suggest that Morning Affect may be better characterised as a general measure of sleep inertia, and may contribute to ongoing development/refinement of questionnaire measures of circadian functioning.
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Affiliation(s)
- Richard Carciofo
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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49
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Zalta AK, Vanderboll K, Dent AL, Contreras IM, Malek N, Lascano XN, Zellner KL, Grandhi J, Araujo PJ, Straka K, Liang CZ, Czarny JE, Martinez J, Burgess HJ. Sleep timing, chronotype, and posttraumatic stress disorder: An individual participant data meta-analysis. Psychiatry Res 2023; 321:115061. [PMID: 36706561 DOI: 10.1016/j.psychres.2023.115061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
Sleep disturbance is a major component of posttraumatic stress disorder (PTSD). The role of circadian disruption is largely overlooked, though many PTSD studies collect proxy markers of circadian timing. This individual participant data (IPD) meta-analysis examined the correlation between sleep timing / chronotype and PTSD severity among individuals diagnosed with PTSD, the standardized mean difference in sleep timing / chronotype for individuals with and without PTSD, and moderators of these relationships. A systematic search was conducted; authors provided IPD for 27 studies and aggregate data for 16 studies (3,011 participants with PTSD; 2,703 participants without PTSD). Two-step meta-analyses were conducted using a random-effects multivariate approach with robust variance estimation. Bedtime and wake time were not significantly associated with PTSD symptoms or diagnosis. Less total sleep time / time in bed was weakly associated with greater PTSD symptoms. Moderator analyses revealed that effect sizes were stronger in certain populations and when using wrist actigraphy to measure sleep timing; however, gap maps revealed few studies in moderator categories with the strongest effects. Only two studies measured chronotype, prohibiting strong conclusions. Our findings indicate that the relationship between sleep timing and PTSD is weak; however, key gaps in the literature warrant further study.
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Affiliation(s)
- Alyson K Zalta
- Department of Psychological Sciences, University of California, Irvine, United States.
| | | | - Amy L Dent
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Isaias M Contreras
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Nadia Malek
- Department of Psychological Sciences, University of California, Irvine, United States; Dissemination and Training Division, National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, United States
| | - Xrystyan N Lascano
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Kelly L Zellner
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Jyotsna Grandhi
- Department of Psychological Sciences, University of California, Irvine, United States; Department of Counseling and Psychological Services, Georgia State University, United States
| | - Precious J Araujo
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Kelci Straka
- Department of Psychological Sciences, University of California, Irvine, United States; School of Social Work, Virginia Commonwealth University, United States
| | - Cathy Z Liang
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Jordyn E Czarny
- Kresge Hearing Research Institute and Department of Otolaryngology, University of Michigan, Ann Arbor, United States; Department of Psychiatry, University of Michigan, United States
| | - Jazmin Martinez
- Department of Psychological Sciences, University of California, Irvine, United States
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, United States
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50
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Cooper R, Di Biase MA, Bei B, Allen NB, Schwartz O, Whittle S, Cropley V. Development of morning-eveningness in adolescence: implications for brain development and psychopathology. J Child Psychol Psychiatry 2023; 64:449-460. [PMID: 36325967 PMCID: PMC10952670 DOI: 10.1111/jcpp.13718] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Morning-evening preference is defined as an individual's preference for a morning- or evening-oriented rhythm. Across adolescence, a preference for eveningness becomes more predominant. Although eveningness is cross-sectionally associated with internalizing and externalizing psychopathology, few studies have examined developmental changes in eveningness and its potential biological substrates. Here, we investigated the longitudinal relationships among the trajectory of eveningness preference, internalizing and externalizing psychopathology and white matter development, across adolescence. METHODS Two-hundred and nine adolescents (49% male) were assessed longitudinally at four separate time points between 12 and 19 years of age. Morning-evening preference and internalizing and externalizing symptoms were assessed at each time point. Diffusion-weighted images were acquired on a subset of participants at the final two time points to estimate changes in global mean fractional anisotropy (FA). Linear mixed models were performed to estimate the change in eveningness over time. A series of linear regression models assessed the influence of change in eveningness on psychopathology and white matter development at age 19. RESULTS Across the sample, a preference for eveningness became more predominant by 19 years of age. Greater individual-level change towards eveningness significantly predicted greater severity in externalizing, but not internalizing, symptoms at 19 years of age. In contrast, change in psychopathology from 12 to 19 years of age was not associated with morning-eveningness at age 19. A change towards eveningness predicted an attenuated increase in FA between 17 and 19 years of age. CONCLUSIONS This study suggests that developmental changes in morning-evening preference may predict both neurodevelopmental and psychological outcomes in adolescents.
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Affiliation(s)
- Rebecca Cooper
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
| | - Maria A. Di Biase
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMelbourneVictoriaAustralia
| | | | - Orli Schwartz
- Orygen Centre for Youth Mental HealthMelbourneVictoriaAustralia
| | - Sarah Whittle
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
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