Significant contribution of chronotype to emotional well-being in chronic psychiatric outpatients in Greece

Abstract

Circadian rhythms are pivotal for human functioning, and their disruption holds significant implications for well-being. One common source for circadian disruptions is circadian misalignment that can be related to chronotypes. Chronotypes refer to an individual's preferred timing for sleep and wakefulness. Individuals with late chronotypes are at a disadvantage in the morning-oriented modern world and are demonstrated to have negative consequences in many aspects of life. In the context of psychiatric disorders, chronotypes are related to prevalence of disorders and to treatment effects but less attention is given to the relationship between chronotype and well-being in chronic psychiatric patients. The current study aims to elucidate the extent to which individual chronotypes contribute to emotional well-being within a cohort of individuals with chronic psychiatric disorder in outpatient clinic. Participants (n = 100) were recruited from the outpatient clinic of the 3rd Department of Psychiatry, AHEPA University Hospital, Thessaloniki, Greece, and the AX Mental Health Outpatient Clinic in Heraklion, Crete, Greece. Most participants were diagnosed within the F2 cluster, Psychotic disorders (n = 38), or F3 cluster, Mood (affective) disorders (n = 48). The Morningness-Eveningness Questionnaire (MEQ) was employed to assess chronotype. The STAI-Y1, CES-D, QoL Uniscale and RASS Questionnaires were used to assess aspects of emotional well-being. A single measure of emotional well-being was generated using Z-score transformation. Student's t-test, ANOVAs and Pearson's correlations were used to identify parameters contributing to emotional well-being, followed by a comprehensive regression model. Results show a significant contribution to emotional well-being by "psychiatric diagnosis" with schizophrenia/schizoaffective patients showing better emotional well-being compared with the "other" group, "receiving treatment" with patients receiving treatment showing higher score than ones who do not receive treatment, and "morningness/eveningness preference" where morningness was associated with higher score of emotional well-being. No other demographic or health-related parameters were significantly associated with emotional well-being score. These findings clearly indicate the critical importance of chronotypes to the emotional well-being of chronic psychiatric patients. Additional thought and research should explore possible chronotherapy interventions that will address this issue in patients.

Keywords: Chronobiology; Emotional well-being; Psychiatry; Sleep.

Fig. 1

Distribution of morningness/eveningness preference (MEQ questionnaire) in the study population. Statistical analysis indicates a normal distribution [Shapiro-Wilk test: W = 0.99, p = 0.68].

Fig. 2

Morningness/eveningness preference is significantly correlated with combined well-being measure [Pearson's correlation, r = 0.23, p = 0.02].