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Ahmed MS, Hasan T, Islam S, Ahmed N. Investigating Rhythmicity in App Usage to Predict Depressive Symptoms: Protocol for Personalized Framework Development and Validation Through a Countrywide Study. JMIR Res Protoc 2024; 13:e51540. [PMID: 38657238 PMCID: PMC11079771 DOI: 10.2196/51540] [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: 08/06/2023] [Revised: 12/27/2023] [Accepted: 01/11/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Understanding a student's depressive symptoms could facilitate significantly more precise diagnosis and treatment. However, few studies have focused on depressive symptom prediction through unobtrusive systems, and these studies are limited by small sample sizes, low performance, and the requirement for higher resources. In addition, research has not explored whether statistically significant rhythms based on different app usage behavioral markers (eg, app usage sessions) exist that could be useful in finding subtle differences to predict with higher accuracy like the models based on rhythms of physiological data. OBJECTIVE The main objective of this study is to explore whether there exist statistically significant rhythms in resource-insensitive app usage behavioral markers and predict depressive symptoms through these marker-based rhythmic features. Another objective of this study is to understand whether there is a potential link between rhythmic features and depressive symptoms. METHODS Through a countrywide study, we collected 2952 students' raw app usage behavioral data and responses to the 9 depressive symptoms in the 9-item Patient Health Questionnaire (PHQ-9). The behavioral data were retrieved through our developed app, which was previously used in our pilot studies in Bangladesh on different research problems. To explore whether there is a rhythm based on app usage data, we will conduct a zero-amplitude test. In addition, we will develop a cosinor model for each participant to extract rhythmic parameters (eg, acrophase). In addition, to obtain a comprehensive picture of the rhythms, we will explore nonparametric rhythmic features (eg, interdaily stability). Furthermore, we will conduct regression analysis to understand the association of rhythmic features with depressive symptoms. Finally, we will develop a personalized multitask learning (MTL) framework to predict symptoms through rhythmic features. RESULTS After applying inclusion criteria (eg, having app usage data of at least 2 days to explore rhythmicity), we kept the data of 2902 (98.31%) students for analysis, with 24.48 million app usage events, and 7 days' app usage of 2849 (98.17%) students. The students are from all 8 divisions of Bangladesh, both public and private universities (19 different universities and 52 different departments). We are analyzing the data and will publish the findings in a peer-reviewed publication. CONCLUSIONS Having an in-depth understanding of app usage rhythms and their connection with depressive symptoms through a countrywide study can significantly help health care professionals and researchers better understand depressed students and may create possibilities for using app usage-based rhythms for intervention. In addition, the MTL framework based on app usage rhythmic features may more accurately predict depressive symptoms due to the rhythms' capability to find subtle differences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51540.
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Affiliation(s)
- Md Sabbir Ahmed
- Design Inclusion and Access Lab, North South University, Dhaka, Bangladesh
| | - Tanvir Hasan
- Design Inclusion and Access Lab, North South University, Dhaka, Bangladesh
| | - Salekul Islam
- Department of Computer Science and Engineering, United International University, Dhaka, Bangladesh
| | - Nova Ahmed
- Design Inclusion and Access Lab, North South University, Dhaka, Bangladesh
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Ferrarelli F. Sleep spindles as neurophysiological biomarkers of schizophrenia. Eur J Neurosci 2024; 59:1907-1917. [PMID: 37885306 DOI: 10.1111/ejn.16178] [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: 06/11/2023] [Revised: 09/17/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
Schizophrenia (SCZ) is a complex psychiatric disorder characterized by a wide range of clinical symptoms, including disrupted sleep. In recent years, there has been growing interest in assessing alterations in sleep parameters in patients with SCZ. Sleep spindles are brief (0.5-2 s) bursts of 12- to 16-Hz rhythmic electroencephalogram (EEG) oscillatory activity occurring during non-rapid eye movement (NREM) sleep. Spindles have been implicated in several critical brain functions, including learning, memory and plasticity, and are thought to reflect the integrity of underlying thalamocortical circuits. This review aims to provide an overview of the current research investigating sleep spindles in SCZ. After briefly describing the neurophysiological features of sleep spindles, I will discuss alterations in spindle characteristics observed in SCZ, their associations with the clinical symptomatology of these patients and their putative underlying neuronal and molecular mechanisms. I will then discuss the utility of sleep spindle measures as predictors of treatment response and disease progression. Finally, I will highlight future directions for research in this emerging field, including the prospect of utilizing sleep spindles as neurophysiological biomarkers of SCZ.
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Affiliation(s)
- Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Martinelli A, Moncalieri G, Zamparini M, Alessandri G, Vittorio Caprara G, Castelnuovo G, Rocchetti M, Starace F, Zarbo C, de Girolamo G. Positivity, daily time use, mood, and functioning in patients with schizophrenia spectrum disorders: Results from the diapason multicentric study. Int J Soc Psychiatry 2024; 70:319-329. [PMID: 38054430 PMCID: PMC10913309 DOI: 10.1177/00207640231212868] [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: 12/07/2023]
Abstract
BACKGROUND Positivity (POS) indicates the proclivity to see life and experiences in a positive light. There is limited research on its effects on individuals with Schizophrenia Spectrum Disorders (SSD). Very little is known about the relationship between POS and daily activities in people with SSD. AIM The study aims to compare the POS rated by patients with SSD with those obtained in an Italian normative sample matched by age and sex and to use the Ecological Momentary Assessment (EMA) to investigate the association between POS and daily time use (i.e. productive activities, leisure activities), functioning and mood in individuals with SSD. METHOD 620 SSD patients were recruited from mental health services in Italy as part of the DiAPAson project. POS, symptom severity, functioning, and quality of life (QoL) were assessed. POS scores were compared to a normative sample of 5,002 Italian citizens. Additionally, a subset of 102 patients underwent 7-day assessments using mobile EMA. RESULTS People with SSD did not significantly differ from the Italian normative sample in POS levels (0.035, p = .190). POS showed a significant inverse association with support network (-0.586, p = .036) and symptomatology (BPRS -0.101; 95% p < .001; BNSS B = -0.113, p < .001). A significant direct association was found between POS and QoL (B = 0.310, p < .001) and functioning (B = 0.058, p < .001). In the subsample using EMA, POS ratings showed significant associations with Positive Emotions (B = 0.167, p < .001) and Negative Emotions (B = -0.201, p < .001). CONCLUSION People with SSD exhibited comparable levels of POS to the normative sample. Higher POS was linked to better functioning, QoL, fewer severe symptoms, and increased positive emotions. However, it did not relate to increased productivity or engagement in leisure activities. Further research is needed to understand the relationship between POS and time use in individuals with SSD.
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Affiliation(s)
- Alessandra Martinelli
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giulia Moncalieri
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Manuel Zamparini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Matteo Rocchetti
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy
| | - Fabrizio Starace
- Department of Mental Health and Dependence, AUSL of Modena, Modena, Italy
| | - Cristina Zarbo
- Department of Psychology, University of Milan Bicocca, Milan, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Boiko DI, Chopra H, Bilal M, Kydon PV, Herasymenko LO, Rud VO, Bodnar LA, Vasylyeva GY, Isakov RI, Zhyvotovska LV, Mehta A, Skrypnikov AM. Schizophrenia and disruption of circadian rhythms: An overview of genetic, metabolic and clinical signs. Schizophr Res 2024; 264:58-70. [PMID: 38101179 DOI: 10.1016/j.schres.2023.12.002] [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: 12/21/2022] [Revised: 07/15/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
A molecular clock in the suprachiasmatic nucleus of the anterior hypothalamus, which is entrained by the dark-light cycle and controls the sleep-wake cycle, regulates circadian rhythms. The risk of developing mental disorders, such as schizophrenia, has long been linked to sleep abnormalities. Additionally, a common aspect of mental disorders is sleep disturbance, which has a direct impact on the intensity of the symptoms and the quality of life of the patient. This relationship can be explained by gene alterations such as CLOCK in schizophrenia which are also important components of the physiological circadian rhythm. The function of dopamine and adenosine in circadian rhythm should also be noted, as these hypotheses are considered to be the most popular theories explaining schizophrenia pathogenesis. Therefore, determining the presence of a causal link between the two can be key to identifying new potential targets in schizophrenia therapy, which can open new avenues for clinical research as well as psychiatric care. We review circadian disruption in schizophrenia at the genetic, metabolic, and clinical levels. We summarize data about clock and clock-controlled genes' alterations, neurotransmitter systems' impairments, and association with chronotype in schizophrenia patients. Our findings demonstrate that in schizophrenia either homeostatic or circadian processes of sleep regulation are disturbed. Also, we found an insufficient number of studies aimed at studying the relationship between known biological phenomena of circadian disorders and clinical signs of schizophrenia.
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Affiliation(s)
- Dmytro I Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine.
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai-602105, Tamil Nadu, India
| | - Muhammad Bilal
- College of Pharmacy, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Pavlo V Kydon
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Larysa O Herasymenko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Vadym O Rud
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Lesia A Bodnar
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Ganna Yu Vasylyeva
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Rustam I Isakov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Liliia V Zhyvotovska
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Aashna Mehta
- University of Debrecen, Faculty of Medicine, Debrecen, Hungary
| | - Andrii M Skrypnikov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
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Seol J, So R, Murai F, Matsuo T. Relationship between rest-activity rhythms and cardiorespiratory fitness in middle-aged workers: a cross-sectional study with non-parametric analysis using accelerometers worn on the thigh. BMC Public Health 2024; 24:62. [PMID: 38166824 PMCID: PMC10763488 DOI: 10.1186/s12889-023-17580-w] [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: 07/19/2023] [Accepted: 12/25/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Rest-activity rhythms are directly related to health risks, but there are limited objective methods to assess them. This study aimed to investigate the relationship between rest-activity rhythms and cardiorespiratory fitness (CRF) in middle-aged workers. METHODS Peak oxygen uptake was measured on a treadmill to assess CRF in 254 middle-aged workers who were divided into low, medium, and high-CRF groups based on tertiles. Participants were asked to wear an accelerometer (activPAL) on their thighs for 1 week, and the logarithmically transformed acceleration data were used for the analysis of a 24-hour rest-activity rhythm. Sex, age, body mass index, occupation, smoking status, and alcohol consumption were used as covariates in Model 1, with Model 2 also including walking count on non-workdays. Repeated measures analysis of variance was used to compare time course of rest-activity rhythms changes on workdays between groups, and post-hoc tests were conducted using Bonferroni's correlation. RESULTS Higher CRF correlated with increased physical activity. In model 1, higher CRF showed improved interdaily stability, but the significant difference disappeared in model 2 after adjusting for non-workday walking counts. A time-course group comparison showed that the high group had significantly higher activity levels than those of the low group from 6:00 to 8:59 and 17:00 to 17:59 and the medium group from 6:00 to 7:59 and 19:00 to 19:59. CONCLUSIONS Workers who have better rest-activity rhythms and engage in higher levels of physical activity on workdays tend to have higher CRF levels. Regular daily routines, influenced by physical activity during holidays, can positively impact cardiopulmonary endurance.
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Affiliation(s)
- Jaehoon Seol
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan (JNIOSH), Nagao 6-21-1, Tama-ku, Kawasaki, Kanagawa, 214-8582, Japan.
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan.
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba, Japan.
| | - Rina So
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan (JNIOSH), Nagao 6-21-1, Tama-ku, Kawasaki, Kanagawa, 214-8582, Japan
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan (JNIOSH), Kawasaki, Kanagawa, Japan
| | - Fumiko Murai
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan (JNIOSH), Nagao 6-21-1, Tama-ku, Kawasaki, Kanagawa, 214-8582, Japan
| | - Tomoaki Matsuo
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan (JNIOSH), Nagao 6-21-1, Tama-ku, Kawasaki, Kanagawa, 214-8582, Japan
- Ergonomics Research Group, National Institute of Occupational Safety and Health, Japan (JNIOSH), Kawasaki, Kanagawa, Japan
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Cai F, Jiang H, Tong S, Zhou S, Wang M, Sun S, Liu J, Xu Y, Lin N, Dai J, Wang X, Wang W, Zhao K, Wu X. Alexithymia is associated with insomnia in Chinese patients with schizophrenia. Front Psychiatry 2023; 14:1252763. [PMID: 38161729 PMCID: PMC10757626 DOI: 10.3389/fpsyt.2023.1252763] [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: 07/04/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024] Open
Abstract
Background Sleep disorders are prevalent among patients with schizophrenia and are associated with several negative consequences. Although, researchers have recently suggested that sleep disorders have a close correlation with alexithymia, and schizophrenia also has a strong correlation with alexithymia, there have been few studies on the relationships between schizophrenia, sleep disorders and alexithymia. Therefore, this study aimed to explore the relationships between psychiatric symptoms, alexithymia and sleep problems in patients with schizophrenia so as to provide a reference for the clinical treatment of this comorbidity. Methods In total, 977 patients with schizophrenia were recruited for this study. The Insomnia Severity Index (ISI) was used to assess sleep disorders, and the Positive and Negative Syndrome Scale (PANSS), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Toronto Alexithymia Scale (TAS) were used to evaluate clinical symptoms, cognitive functions and the ability to express emotion, respectively. Results The results indicated that the PANSS subscales (G-subscore) and TAS group were risk factors for insomnia in schizophrenia patients (all p < 0.05). The mediation model showed the standardized path coefficients from schizophrenia to alexithymia (β = 0.104, p < 0.001) and from alexithymia to insomnia (β = 0.038, p < 0.001) were statistically significant. Conclusion The results of this study indicated that alexithymia is associated with sleep disturbance in patients with schizophrenia. These findings may provide a new avenue for the treatment of schizophrenia patients with sleep disorders.
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Affiliation(s)
- Fangfang Cai
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Huixia Jiang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Siyao Zhou
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Mengpu Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Shiyu Sun
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Nankai Lin
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jiajing Dai
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Xinyao Wang
- Renji College of Wenzhou Medical University, Wenzhou, China
| | - Wei Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Lishui Second People’s Hospital Affiliated to Wenzhou Medical University, Lishui, China
- The Affiliated Kangning Hospital of Wenzhou Medical University, Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China
| | - Xixi Wu
- Wenzhou Lucheng District Third People’s Hospital, Wenzhou, China
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Licinio J, Wong ML. Psychosis and autism spectrum disorder: a special issue of Molecular Psychiatry. Mol Psychiatry 2023; 28:1830-1832. [PMID: 37833367 DOI: 10.1038/s41380-023-02250-5] [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] [Indexed: 10/15/2023]
Affiliation(s)
- Julio Licinio
- State University of New York, Upstate Medical University, Syracuse, NY, 13210, USA.
| | - Ma-Li Wong
- State University of New York, Upstate Medical University, Syracuse, NY, 13210, USA
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Luo H, Wang X, Zhang Y, Li J, Hu R, Zhang Z, Liao Q, Zhou X, Deng W, Yang J, Luo Q. Can circadian rhythm predict changes in neurocognitive functioning in bipolar disorder: protocol of a 12-month longitudinal cohort study based on research domain criteria. Ann Med 2023; 55:2240422. [PMID: 37506182 PMCID: PMC10392262 DOI: 10.1080/07853890.2023.2240422] [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: 05/23/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Introduction: Bipolar disorder (BD) is a prevalent and disabling mental disorder characterized by disrupted circadian rhythms and impaired neurocognitive features, both of which fall under the major domains of Research Domain Criteria (RDoC). However, there is limited evidence regarding the interaction between circadian rhythms and long-term neurocognitive functioning. Therefore, this longitudinal cohort study protocol aims to explore whether circadian rhythm can predict changes in neurocognitive functioning over time in patients with BD.Methods: This study adopts a longitudinal cohort design, aiming to recruit 100 BD patients in either depressive or remitted states. Participants will undergo evaluations from clinical, circadian rhythm, and neurocognitive perspectives at baseline, 6-month, and 12-month follow-ups, involving questionnaires, actigraphy, and computed neurocognitive tests. We will examine both cross-sectional and longitudinal associations between participants' circadian rhythm patterns and neurocognitive functioning. Statistical analyses will employ Spearman correlation and mixed regression models.Discussion: We anticipate that circadian rhythms may serve as predictors of neurocognitive functioning changes. The findings of this study could offer supplementary insights into BD pathophysiology, potential treatment targets, and prediction.Trial Registration: This study has been registered with the Chinese Clinical Trial Registry under the registration code ChiCTR2200064922 on 21st October 2022.
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Affiliation(s)
- Huirong Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueqian Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yinlin Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Junyao Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqin Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zheng Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Liao
- Department of Laboratory Diagnostic, Chongqing KingMed Institute for Clinical Laboratory Co.LTD, Chongqing, China
| | - Xiaoxin Zhou
- Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Deng
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Jian Yang
- Research Center for Metabolic and Cardiovascular Diseases, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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