Chronotype and Psychiatric Disorders

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Abstract

Purpose of Review

Chronotype, reflecting interindividual differences in daily activity patterns and sleep-wake cycles, is intrinsically connected with well-being. Research indicates increased risk of many adverse mental health outcomes for evening-type individuals. Here, we provide an overview of the current evidence available on the relationship between chronotype and psychiatric disorders.

Recent Findings

The association between eveningness and depression is well established cross-sectionally, with preliminary support from longitudinal studies. The mechanisms underlying this relationship warrant further research; deficient cognitive-emotional processes have recently been implicated. Eveningness is associated with unhealthy lifestyle habits, and the propensity of evening types to addiction has been recognized. Chronotype may also be implicated in disordered eating.

Summary

Eveningness is associated with depression—including seasonal affective disorder (SAD)—and substance dependence, while support for a relation with anxiety disorders and psychosis is lacking. In bipolar disorder, chronotype is linked to depression but not mania. Eveningness is also related to sleep disturbances and poor lifestyle habits, which may increase risk for psychiatric disorders.

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Most cited references 82

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Circadian typology: a comprehensive review.

Ana Adan, Simon Archer, Maria Hidalgo … (2012)

The interest in the systematic study of the circadian typology (CT) is relatively recent and has developed rapidly in the two last decades. All the existing data suggest that this individual difference affects our biological and psychological functioning, not only in health, but also in disease. In the present study, we review the current literature concerning the psychometric properties and validity of CT measures as well as individual, environmental and genetic factors that influence the CT. We present a brief overview of the biological markers that are used to define differences between CT groups (sleep-wake cycle, body temperature, cortisol and melatonin), and we assess the implications for CT and adjustment to shiftwork and jet lag. We also review the differences between CT in terms of cognitive abilities, personality traits and the incidence of psychiatric disorders. When necessary, we have emphasized the methodological limitations that exist today and suggested some future avenues of work in order to overcome these. This is a new field of interest to professionals in many different areas (research, labor, academic and clinical), and this review provides a state of the art discussion to allow professionals to integrate chronobiological aspects of human behavior into their daily practice.

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The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence.

Robert Golden, Bradley Gaynes, R Ekstrom … (2005)

The purpose of this study was to assess the evidence base for the efficacy of light therapy in treating mood disorders. The authors systematically searched PubMed (January 1975 to July 2003) to identify randomized, controlled trials of light therapy for mood disorders that fulfilled predefined criteria. These articles were abstracted, and data were synthesized by disease and intervention category. Only 13% of the studies met the inclusion criteria. Meta-analyses revealed that a significant reduction in depression symptom severity was associated with bright light treatment (eight studies, having an effect size of 0.84 and 95% confidence interval [CI] of 0.60 to 1.08) and dawn simulation in seasonal affective disorder (five studies; effect size=0.73, 95% CI=0.37 to 1.08) and with bright light treatment in nonseasonal depression (three studies; effect size=0.53, 95% CI=0.18 to 0.89). Bright light as an adjunct to antidepressant pharmacotherapy for nonseasonal depression was not effective (five studies; effect size=-0.01, 95% CI=-0.36 to 0.34). Many reports of the efficacy of light therapy are not based on rigorous study designs. This analysis of randomized, controlled trials suggests that bright light treatment and dawn simulation for seasonal affective disorder and bright light for nonseasonal depression are efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials. Adopting standard approaches to light therapy's specific issues (e.g., defining parameters of active versus placebo conditions) and incorporating rigorous designs (e.g., adequate group sizes, randomized assignment) are necessary to evaluate light therapy for mood disorders.

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Circadian preference, sleep and daytime behaviour in adolescence.

Flavia Giannotti, Flavia Cortesi, Teresa Sebastiani … (2002)

The aim of this study was to determine the relationship between circadian preferences, regularity of sleep patterns, sleep problems, daytime sleepiness and daytime behaviour. As a part of an epidemiological survey on sleep in a representative sample of Italian high-school students, a total of 6631 adolescents, aged 14.1-18.6 years, completed the School Sleep Habits Survey, a comprehensive questionnaire including items regarding sleep, sleepiness, substance use, anxiety and depressed mood, use of sleeping pills, school attendance and a morningness/eveningness scale. The sample consisted of 742 evening-types (315 males and 427 females; mean age 17.1 years) and 1005 morning-types (451 males and 554 females; mean age 16.8 years). No significant sex differences were found for morningness/eveningness score. Eveningness was associated with later bedtime and wake-up time, especially on weekends, shorter time in bed during the week, longer weekend time in bed, irregular sleep-wake schedule, subjective poor sleep. Moreover, evening types used to nap more frequently during school days, complained of daytime sleepiness, referred more attention problems, poor school achievement, more injuries and were more emotionally upset than the other chronotype. They referred also greater caffeine-containing beverages and substances to promote sleep consumption. Our results suggest that circadian preference might be related not only to sleep pattern, but also to other adolescent behaviours.

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Author and article information

Contributors

Niki Antypa: +31 (0)71 527 6677 , nantypa@fsw.leidenuniv.nl

Journal

Journal ID (nlm-ta): Curr Sleep Med Rep

Journal ID (iso-abbrev): Curr Sleep Med Rep

Title: Current Sleep Medicine Reports

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2198-6401

Publication date (Electronic): 16 April 2018

Publication date PMC-release: 16 April 2018

Publication date (Print): 2018

Volume: 4

Issue: 2

Pages: 94-103

Affiliations

ISNI 0000 0001 2312 1970, GRID grid.5132.5, Department of Clinical Psychology, Institute of Psychology, , Leiden University, ; Wassenaarseweg 52, 2333 AK Leiden, The Netherlands

Article

Publisher ID: 113

DOI: 10.1007/s40675-018-0113-8

PMC ID: 5972175

PubMed ID: 29888167

SO-VID: 8822083e-d175-4061-83ae-137fb438c78c

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Funding

Funded by: Leiden University

Custom metadata

Keywords: chronotype,eveningness,depression,seasonal affective disorder,delayed sleep phase syndrome,substance abuse,eating disorder,bipolar disorder,anxiety disorder

Data availability:

Keywords: chronotype, eveningness, depression, seasonal affective disorder, delayed sleep phase syndrome, substance abuse, eating disorder, bipolar disorder, anxiety disorder

Chronotype and Psychiatric Disorders

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Abstract

Purpose of Review

Recent Findings

Summary

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Psychiatric Research and Clinical Practice

Most cited references 82

Circadian typology: a comprehensive review.

The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence.

Circadian preference, sleep and daytime behaviour in adolescence.

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