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      Eveningness is associated with poor sleep quality and negative affect in obsessive–compulsive disorder


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          Obsessive–compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors that severely encumber daily functioning. OCD patients seem to exhibit sleep disturbances, especially delayed bedtimes that reflect disrupted circadian rhythmicity. Morningness–eveningness is a fundamental factor reflecting individual variations in diurnal preferences related to sleep and waking activities. Eveningness reflecting a delayed sleep–wake timing has repeatedly been associated with sleep problems and negative affect (NA). Therefore, the aim of this study was to examine the associations between morningness–eveningness, sleep complaints, and symptom severity in OCD patients and compared with a mixed psychiatric control group.

          Materials and methods

          The data of 49 OCD and 49 mixed psychiatric inpatients (with unipolar depression and anxiety disorders) were analyzed. Patients completed questionnaires regarding morningness–eveningness, sleep quality, nightmare frequency, depression, anxiety, and affective states. Obsessive and compulsive symptom severity was also assessed within the OCD group by clinician-rated scales.


          Eveningness preference was associated with impaired sleep quality and higher NA in OCD patients. In addition, impaired sleep quality showed a moderate correlation with anxiety and strong correlations with depressive symptoms and NA. Interestingly, in the mixed psychiatric group, eveningness was not linked to NA, and sleep quality also showed weaker associations with depressive symptoms and NA. Within the OCD group, eveningness preference was predictive of poorer sleep quality regardless the influence of depressive symptoms.


          Our findings suggest that eveningness and sleep complaints are predictive of affective dysfunctions, and should be carefully considered in the evaluation and treatment of OCD patients.

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          Most cited references66

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          Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing

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            The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

            Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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              Development and validation of brief measures of positive and negative affect: The PANAS scales.

              In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.

                Author and article information

                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                07 February 2018
                March 2018
                : 7
                : 1
                : 10-20
                [ 1 ] Institute of Psychology, Eötvös Loránd University , Budapest, Hungary
                [ 2 ] Nyírő Gyula Hospital, National Institute of Psychiatry and Addictions , Budapest, Hungary
                [ 3 ] Semmelweis University , Budapest, Hungary
                [ 4 ]Faculty of Medicine and Health Sciences, University of East Anglia , Norwich, United Kingdom
                [ 5 ]Department of Cognitive Sciences, Budapest University of Technology and Economics , Budapest, Hungary
                [ 6 ]Rehabilitation Department of Brain Injuries, National Institute of Medical Rehabilitation , Budapest, Hungary
                [ 7 ]Learning and Memory Disorders Research Group, Research Centre for Natural Sciences, Hungarian Academy of Sciences , Budapest, Hungary
                Author notes
                [* ]Corresponding author: Péter Simor, PhD; Department of Affective Psychology, Eötvös Loránd University, Izabella utca 46, Budapest 1064, Hungary; Phone: +36 1 461 2691; Fax: +36 1 461 4500/5675; E-mail: simor.peter@ 123456ppk.elte.hu
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                : 16 November 2017
                : 18 January 2018
                : 21 January 2018
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 64, Pages: 11
                Funding sources: PS was supported by the Hungarian Scientific Research Fund (NKFI PD 115432) of the National Research, Development and Innovation Office and by the János Bolyai Fellowship of the Hungarian Academy of Sciences.
                FULL-LENGTH REPORT

                Medicine,Psychology,Social & Behavioral Sciences,Clinical Psychology & Psychiatry
                affect,sleep,morningness–eveningness,obsessive–compulsive disorder,chronotype


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