Eveningness chronotype preference among individuals at clinical high risk for psychosis

Jessica R Lunsford-Avery; Andrea Pelletier-Baldelli; Stephanie A Korenic; Jason Schiffman; Lauren M Ellman; Leah Jackson; Vijay A Mittal

doi:10.1016/j.schres.2021.07.034

Eveningness chronotype preference among individuals at clinical high risk for psychosis

Schizophr Res. 2021 Oct:236:3-8. doi: 10.1016/j.schres.2021.07.034. Epub 2021 Aug 4.

Authors

Jessica R Lunsford-Avery¹, Andrea Pelletier-Baldelli², Stephanie A Korenic³, Jason Schiffman⁴, Lauren M Ellman³, Leah Jackson⁵, Vijay A Mittal⁶

Affiliations

¹ Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA. Electronic address: jessica.r.avery@duke.edu.
² University of North Carolina Chapel Hill, Department of Psychiatry, Chapel Hill, NC, USA.
³ Temple University, Department of Psychology, Philadelphia, PA, USA.
⁴ University of Maryland Baltimore County, Department of Psychology, Baltimore, MD, USA.
⁵ Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Durham, NC, USA.
⁶ Northwestern University, Department of Psychology, Evanston, IL, USA; Northwestern University, Department of Psychiatry, Evanston, IL, USA; Northwestern University, Institute for Policy Research, Evanston, IL, USA; Northwestern University, Department of Medical Social Science, Evanston, IL, USA.

Abstract

Background: Circadian rhythm disturbances are frequently implicated in psychosis. Indeed, research has suggested several avenues by which circadian rhythms may play a mechanistic role as well as contribute to clinical outcomes. Despite its potential role as a risk factor, little is known about circadian rhythm disruption among individuals at clinical high risk (CHR) for psychosis, clinical correlates, or specificity to the psychosis risk syndrome.

Methods: Eighty-four CHR, 74 individuals with depressive disorders (DD), and 101 non-psychiatric controls (NPC) participated in structured clinical interviews and provided self-reports of chronotype preference. Clinical (positive, negative, anxious, and depressive symptoms) and social functioning outcomes were self-reported and/or clinician-rated. Analyses of covariance controlling for demographics examined group differences in chronotype preference, and partial Pearson correlations evaluated associations with clinical/functional outcomes.

Results: Group differences were observed (F(11, 246) = 8.05, p < .001) with CHR and DD individuals indicating greater eveningness preference compared to NPC. A follow-up sensitivity analysis examining CHR participants with (n = 25) and without (n = 59) depressive disorders indicated no difference in chronotype preference (F(10,72) = 0.00, p = .99). Greater eveningness preference was related to greater negative symptoms (i.e., avolition; r = -0.25) and anxiety (r = -0.34) among CHR individuals.

Conclusions: CHR and DD display greater preference for eveningness chronotype compared to NPC indicating the disruption is associated with a range of mental health concerns, and not specific to the psychosis-risk syndrome. However, comorbidity with DD did not appear to be driving the finding in the CHR group. Further research may examine shared versus non-shared underlying mechanisms contributing to chronotype preference across psychiatric presentations.

Keywords: Chronotype; Circadian rhythms; Clinical high risk; Diurnal preference; Psychosis; Schizophrenia.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Anxiety
Circadian Rhythm*
Humans
Psychotic Disorders* / complications
Risk Factors
Self Report
Sleep
Surveys and Questionnaires

Abstract

Publication types

MeSH terms

Grants and funding