Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region.
Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region.
J Clin Sleep Med. 2022 Feb 1;18(2):523-531. doi: 10.5664/jcsm.9648.
Eveningness is associated with worse outcomes in depression. It remained unclear if eveningness could be altered with chronobiological therapy and whether such a change would predict long-term outcomes of depression.
Data from a randomized controlled trial of 5-week adjunctive bright light therapy with a gradual advance protocol conducted in 91 adult patients with nonseasonal unipolar depression and eveningness (Morningness-Eveningness Questionnaire, score ≤ 41) was examined. "Change of eveningness" was defined by Morningness-Eveningness Questionnaire score over 41 at posttreatment week 5 and "persistent change of eveningness" was defined as maintenance of Morningness-Eveningness Questionnaire score > 41 throughout the follow-up period from week 5 to posttreatment 5 months.
Thirty-three participants (36%) had change of eveningness at week 5. Generalized estimating equations models showed that a change of eveningness at week 5 predicted a 2-fold increase in remission of depression over the 5-month follow up (odds ratio = 2.61 95% confidence interval 1.20-5.71, = .016). Twenty-five participants (75.7%) had a persistent change and were more likely to achieve a remission of depression over the 5-month follow up (odds ratio = 3.18, 95% confidence interval: 1.35-7.50, = .008).
One-third of the patients with depression changed their evening-preference after 5-week of chronotherapeutic treatment, and such change predicted a higher likelihood of depression remission over 5 months of follow-up.
Registry: Chinese Clinical Trial Registry; Name: Adjunctive light treatment in major depressive disorder patients with evening chronotype-A randomized controlled trial; URL: https://www.chictr.org.cn/showprojen.aspx?proj=11672; Identifier: ChiCTR-IOR-15006937.
Chan JWY, Chan NY, Li SX, et al. Change in circadian preference predicts sustained treatment outcomes in patients with unipolar depression and evening preference. . 2022;18(2):523-531.
夜晚型与抑郁症的预后较差有关。目前尚不清楚夜晚型是否可以通过生物节律疗法改变，以及这种改变是否可以预测抑郁症的长期预后。
对 91 名非季节性单相抑郁且夜晚型（晨型-夜晚型问卷评分≤41）成年患者进行为期 5 周的辅助强光治疗和逐渐提前方案的随机对照试验的数据进行了检查。“夜晚型变化”定义为治疗后第 5 周晨型-夜晚型问卷评分>41，“持续夜晚型变化”定义为第 5 周至治疗后 5 个月的随访期间晨型-夜晚型问卷评分>41。
33 名参与者（36%）在第 5 周时出现夜晚型变化。广义估计方程模型显示，第 5 周时夜晚型的变化预测了抑郁缓解的可能性在 5 个月的随访中增加了 2 倍（优势比=2.61，95%置信区间为 1.20-5.71，P=0.016）。25 名参与者（75.7%）出现持续的变化，并且在 5 个月的随访中更有可能达到抑郁缓解（优势比=3.18，95%置信区间：1.35-7.50，P=0.008）。
三分之一的抑郁症患者在接受 5 周的时间治疗后改变了他们的夜晚偏好，这种变化预测了在 5 个月的随访中抑郁缓解的可能性更高。
注册机构：中国临床试验注册中心；名称：辅助光治疗单相抑郁患者夜晚型-A 随机对照试验；网址：https://www.chictr.org.cn/showprojen.aspx?proj=11672；标识符：ChiCTR-IOR-15006937。
Chan JWY, Chan NY, Li SX, et al. Change in circadian preference predicts sustained treatment outcomes in patients with unipolar depression and evening preference.. 2022;18(2):523-531.
