Dynamic modelling of chronotype and hypo/manic and depressive symptoms in young people with emerging mental disorders

ABSTRACT

There is significant interest in the possible influence of chronotype on clinical states in young people with emerging mental disorders. We apply a dynamic approach (bivariate latent change score modelling) to examine the possible prospective influence of chronotype on depressive and hypo/manic symptoms in a youth cohort with predominantly depressive, bipolar, and psychotic disorders (N = 118; 14–30-years), who completed a baseline and follow-up assessment of these constructs (mean interval = 1.8-years). Our primary hypotheses were that greater baseline eveningness would predict increases in depressive but not hypo/manic symptoms. We found moderate to strong autoregressive effects for chronotype (β = -0.447 to −0.448, p < 0.001), depressive (β = -0.650, p < 0.001) and hypo/manic symptoms (β = -0.819, p < 0.001). Against our predictions, baseline chronotypes did not predict change in depressive (β = -0.016, p = 0.810) or hypo/manic symptoms (β = 0.077, p = 0.104). Similarly, the change in chronotype did not correlate with the change in depressive symptoms (β = -0.096, p = 0.295) nor did the change in chronotype and the change in hypo/manic symptoms (β = -0.166, p = 0.070). These data suggest that chronotypes may have low utility for predicting future hypo/manic and depressive symptoms in the short term, or that more frequent assessments over longer periods are needed to observe these associations. Future studies should test whether other circadian phenotypes (e.g. sleep-wake variability) are better indicators of illness course.

KEYWORDS:

• Diurnal preference
• circadian preference
• mood disorders
• psychopathology
• depression
• mania
• bipolar
• psychosis

Acknowledgments

The authors acknowledge the Gadigal people of the Eora nation, upon whose ancestral lands our research was conducted; we pay our respect to elders past and present; and we acknowledge all First Nations Australians, in their ongoing struggles for sovereignty and justice. Finally, we express our gratitude to the young people who participated in this research.

Disclosure statement

The authors declare that there are no competing financial interests in relation to the work described. Potential conflicts of interest may arise from the following: IBH is the Co-Director, Health and Policy at the Brain and Mind Centre (BMC) University of Sydney, Australia. The BMC operates an early-intervention youth services at Camperdown under contract to headspace. IBH has previously led community-based and pharmaceutical industry-supported (Wyeth, Eli Lily, Servier, Pfizer, AstraZeneca) projects focused on the identification and better management of anxiety and depression. He is the Chief Scientific Advisor to, and a 3.2% equity shareholder in, InnoWell Pty Ltd. InnoWell was formed by the University of Sydney (45% equity) and PwC (Australia; 45% equity) to deliver the $30 M Australian Government-funded Project Synergy (2017-20) and to lead transformation of mental health services internationally through the use of innovative technologies. EMS is the Medical Director, Young Adult Mental Health Unit, St Vincent’s Hospital Darlinghurst, Discipline Leader of Adult Mental Health, School of Medicine, University of Notre Dame, Research Affiliate, The University of Sydney and Consultant Psychiatrist. She has received honoraria for educational seminars related to the clinical management of depressive disorders supported by Servier and Eli-Lilly pharmaceuticals. She has participated in a national advisory board for the antidepressant compound Pristiq, manufactured by Pfizer. She was the National Coordinator of an antidepressant trial sponsored by Servier.

Author contributions (contributor roles taxonomy)

TW: Formal analysis; methodology; software; visualization; writing – original draft; writing – review & editing. JSC: Investigation; writing – review & editing. EMS: Funding acquisition; investigation; project administration; writing – review & editing. AJG: Investigation; writing – review & editing. PV: Writing – review & editing. JS: Writing – review & editing. DFH: Funding acquisition; investigation; project administration; writing – review & editing. IBH: Conceptualization; funding acquisition; investigation; project administration; resources; supervision; writing – review & editing. JJC: Conceptualization; formal analysis; funding acquisition; investigation; methodology; supervision; visualization; writing – original draft; writing – review & editing.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07420528.2023.2203241.

Additional information

Funding

This study was supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship (2008197; awarded to JJC), two NHMRC Centre of Research Excellence grants (1061043, 117190), an NHMRC Australia Fellowship (511912; awarded to IBH), and philanthropic donations from families affected by mental illness (who would like to be left anonymous).