Müller Matthias Johannes, Cabanel Nicole, Olschinski Christiane, Jochim Dorothee, Kundermann Bernd
a Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, and Justus-Liebig University of Giessen , Germany and.
b Vitos Clinic for Psychiatry and Psychotherapy Giessen , Germany.
Chronobiol Int. 2015;32(10):1343-51. doi: 10.3109/07420528.2015.1091353. Epub 2015 Nov 5.
The individual's chronotype is regarded as rather stable trait with substantial heritability and normal distribution of the "morningness-eveningness" dimension in the general population. Eveningness has been related to the risk of developing affective, particularly depressive, disorders. However, age and other sociobiological factors may influence chronotypes. The present study investigated the distribution, stability, and clinical correlates of chronotype and morningness-eveningness in hospitalized patients with affective disorder. Chronotype was assessed with the morningness-eveningness questionnaire (MEQ) in 93 patients with nonseasonal depressive syndrome (85% major depression; 15% depressive adjustment disorder) after admission, and in 19 patients again before discharge. Distribution, stability and correlations of MEQ scores with clinical variables were calculated. Additionally, a literature analysis of chronotype distributions in samples of nondepressed persons and patients with nonseasonal depression was carried out. MEQ scores (mean 49 ± 11, range 23-75, higher scores indicate morningness) in 93 acutely depressed inpatients (age 41 ± 14 years, range 18-75 years; 63% women; hospitalization 48 ± 22 days; BDI-II 32 ± 11) were normally distributed (Shapiro-Wilk test; W = 0.993, p = 0.920) with 59.1% intermediate types, 19.4% evening types, and 21.5% morning types. MEQ change scores from admission to discharge were nonsignificant (-1.3 ± 5.0; paired t-test, t18 = -1.09; p = 0.29) despite significantly improved depression scores (-19.4 ± 7.6; paired t-test, t18 = 11.2, p < 0.001). Age (r = 0.24), and depression scores (r = -0.21) correlated significantly (p < 0.05) with MEQ scores; associations with sex and hospitalization duration were nonsignificant. The present study and literature findings revealed that the frequency of evening types is not clearly elevated in depression, but morning types are less frequent compared to healthy samples (p < 0.001). Morningness-eveningness scores were normally distributed and stable in depressive inpatients. In line with previous findings, but contrary to theoretical assumptions, evening types were not overrepresented in depressed patients. Additionally, relatively less morning types and more intermediate types were found in depressed patients. Future studies should focus on transitions from morning to intermediate types as a tentative risk or correlate of emerging depression.
个体的昼夜节律类型被视为一种相当稳定的特质，具有较高的遗传性，且在普通人群中“晨型-夜型”维度呈正态分布。夜型与情感障碍尤其是抑郁症的发病风险有关。然而，年龄和其他社会生物学因素可能会影响昼夜节律类型。本研究调查了情感障碍住院患者的昼夜节律类型、晨型-夜型的分布、稳定性及其临床相关性。采用晨型-夜型问卷（MEQ）对93例非季节性抑郁综合征患者（85%为重度抑郁症；15%为抑郁性适应障碍）入院后进行评估，并在19例患者出院前再次评估。计算MEQ评分的分布、稳定性以及与临床变量的相关性。此外，还对非抑郁人群和非季节性抑郁症患者样本中的昼夜节律类型分布进行了文献分析。93例急性抑郁住院患者（年龄41±14岁，范围18 - 75岁；63%为女性；住院时间48±22天；BDI-II评分为32±11）的MEQ评分（平均49±11，范围23 - 75，分数越高表明越倾向晨型）呈正态分布（Shapiro-Wilk检验；W = 0.993，p = 0.920），其中59.1%为中间型，19.4%为夜型，21.5%为晨型。尽管抑郁评分显著改善（-19.4±7.6；配对t检验，t18 = 11.2，p < 0.001），但从入院到出院的MEQ变化评分无显著差异（-1.3±5.0；配对t检验，t18 = -1.09；p = 0.29）。年龄（r = 0.24）和抑郁评分（r = -0.21）与MEQ评分显著相关（p < 0.05）；与性别和住院时间的关联无显著意义。本研究及文献结果表明，抑郁症患者中夜型的频率并未明显升高，但与健康样本相比，晨型的频率较低（p < 0.001）。抑郁住院患者的晨型-夜型评分呈正态分布且稳定。与先前的研究结果一致，但与理论假设相反，抑郁症患者中夜型并未占多数。此外，抑郁症患者中晨型相对较少，中间型较多。未来的研究应关注从晨型向中间型的转变，将其作为新发抑郁症的一种潜在风险或相关因素。
