Department of Integrative Physiology, University of Colorado, 1725 Pleasant Street Ramaley N368, 354 UCB, Boulder, CO 80309-0354, USA; Broad Institute of MIT and Harvard, Program of Medical and Population Genetics, 415 Main Street, Cambridge, MA 02142, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
J Psychiatr Res. 2018 Aug;103:156-160. doi: 10.1016/j.jpsychires.2018.05.022. Epub 2018 May 25.
Prior cross-sectional studies have suggested that being a late chronotype is associated with depression and depressive symptoms, but prospective data are lacking.
We examined the association between chronotype and incident depression (defined as self-reported physician/clinician-diagnosed depression or antidepressant medication use) in 32,470 female participants of the Nurses' Health Study II cohort who self-reported their chronotype (early, intermediate or late) and were free of depression at baseline in 2009 (average age: 55 yrs). Women updated their depression status on biennial questionnaires in 2011 and 2013. We used multivariable (MV)-adjusted Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for incident depression across chronotype categories (i.e., early, intermediate, and late chronotypes).
Across a follow-up period of 4 years, we observed 2,581 cases of incident depression in this cohort. Compared to intermediate chronotypes, early chronotypes had a modestly lower risk of depression after MV adjustment (MVHR = 0.88, 95%CI = 0.81-0.96), whereas late chronotypes had a similar risk of 1.06 (95%CI = 0.93-1.20); the overall trend across chronotype categories was statistically significant (ptrend<0.01). Results were similar when we restricted analyses to women who reported average sleep durations (7-8 h/day) and no history of rotating night shift work at baseline.
Our results suggest that chronotype may influence the risk of depression in middle-to older-aged women. Additional studies are needed to confirm these findings and examine roles of both environmental and genetic factors to further our understanding of the role of chronotype in the etiology of mood disorders.
先前的横断面研究表明，晚时型与抑郁和抑郁症状有关，但缺乏前瞻性数据。
我们在护士健康研究 II 队列的 32470 名女性参与者中检查了时型与新发抑郁症（定义为自我报告的医生/临床医生诊断的抑郁症或使用抗抑郁药物）之间的关联，这些女性在 2009 年基线时报告了自己的时型（早、中或晚）且无抑郁症（平均年龄：55 岁）。女性在 2011 年和 2013 年的两年一次的问卷调查中更新了她们的抑郁状况。我们使用多变量（MV）调整的 Cox 比例风险模型来估计不同时型类别（即早、中、晚时型）的新发抑郁症的风险比（HR）和 95%置信区间（95%CI）。
在 4 年的随访期间，我们在该队列中观察到 2581 例新发抑郁症病例。与中间时型相比，MV 调整后早时型的抑郁风险略低（MVHR=0.88，95%CI=0.81-0.96），而晚时型的风险相似（HR=1.06，95%CI=0.93-1.20）；整个时型类别的趋势具有统计学意义（ptrend<0.01）。当我们将分析仅限于报告平均睡眠时间（7-8 小时/天）且基线时无轮班夜班工作史的女性时，结果相似。
我们的结果表明，时型可能会影响中老年女性的抑郁风险。需要进一步的研究来证实这些发现，并研究环境和遗传因素的作用，以进一步了解时型在情绪障碍发病机制中的作用。
