Seasonal patterns in Chinese population: Validating the seasonal pattern assessment questionnaire and exploring associations with psychiatric diagnoses and biological rhythms

ABSTRACT

Seasonal patterns (SP) exert a notable influence on the course and prognosis of patients with affective disorders, serving as a specifier in diagnosis. However, there is limited exploration of seasonality among psychotic patients, and the distinctions in seasonality among psychiatric patients remain unclear. In this study, we enrolled 198 psychiatric patients with anxiety and depressive disorders (A&D), bipolar disorder (BD), and schizophrenia (SZ), as well as healthy college students. Online questionnaires, including the Seasonal Pattern Assessment Questionnaire (SPAQ) for seasonality, the Morningness and Eveningness Questionnaire-5 (MEQ-5) for chronotypes, and the Pittsburgh Sleep Quality Index (PSQI), were administered. The validity and reliability of the Chinese version of the SPAQ were thoroughly analyzed, revealing a Cronbach’s alpha of 0.896 with a two-factor structure. Results indicated that higher seasonality was correlated with poorer sleep quality and a more delayed chronotype (p < 0.05). Significant monthly variations were particularly evident in BD, specifically in mood, appetite, weight, social activities, and sleep dimensions (p < 0.001). In summary, the Chinese version of SPAQ is validated, demonstrating moderate correlations between seasonality, chronotype, and sleep quality. BD patients exhibited the strongest seasonality, while mood disorder patients displayed more delayed chronotypes than SZ.

KEYWORDS:

• Seasonality
• circadian rhythm
• chronotype
• bipolar disorder
• schizophrenia

Acknowledgments

We thank Tino for questionnaire translation and back-translation.

Disclosure statement

We disclosed all the relevant information with regard to conflict of interest and affiliations. This study is not funded by any private or commercial organization. We declare that our study is accurate and transparent and we did not omit any data. This study does not have any other potential conflict of interest.

Authors’ contributions

All authors contributed to the design and implementation of the research. LQH and LHR designed this study. LHR, CJ and ZZ recruited patients and healthy controls. LHR and LJY processed the data and performed the analysis along with designing of figures and tables. LHR, ZYL and WXQ wrote the first draft. HRQ and GYW revised the manuscript. All authors have reviewed the manuscript and approved the final version.

Availability of data and materials

The data used during the current study are available from the corresponding author on reasonable request.

Consent for publication

All authors approved publication of this research. No identifiable information of participants was presented in this study.

Ethics approval and consent to participate

This study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University (2022–065). This study is conducted in compliance with Helsinki Declaration of Ethics, and all participants agreed to participate in this study with signed informed consent.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07420528.2024.2337875.

Additional information

Funding

This study was funded by Program for Youth Innovation in Future Medicine of Chongqing Medical University [project number: w0107].