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Published in: European Child & Adolescent Psychiatry 10/2017

01-10-2017 | Original Contribution

Not later, but longer: sleep, chronotype and light exposure in adolescents with remitted depression compared to healthy controls

Authors: Lena Katharina Keller, Barbara Grünewald, Céline Vetter, Till Roenneberg, Gerd Schulte-Körne

Published in: European Child & Adolescent Psychiatry | Issue 10/2017

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Abstract

The relationship between sleep and adolescent depression is much discussed, but still not fully understood. One important sleep variable is self-selected sleep timing, which is also referred to as chronotype. Chronotype is mostly regulated by the circadian clock that synchronises the internal time of the body with the external light dark cycle. A late chronotype as well as a misalignment between internal time and external time such as social jetlag has been shown to be associated with depressive symptoms in adults. In this study, we investigated whether adolescents with remitted depression differ from healthy controls in terms of chronotype, social jetlag and other sleep-related variables. For this purpose, we assessed chronotype and social jetlag with the Munich ChronoType Questionnaire (MCTQ), subjective sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and used continuous wrist-actimetry over 31 consecutive days to determine objective sleep timing. Given the potentially mediating effect of light on chronotype and depressive symptoms, we measured light exposure with a light sensor on the actimeter. In our sample, adolescents with remitted depression showed similar chronotypes and similar amounts of social jetlag compared to controls. However, patients with remitted depression slept significantly longer on work-free days and reported a worse subjective sleep quality than controls. Additionally, light exposure in remitted patients was significantly higher, but this finding was mediated by living in a rural environment. These findings indicate that chronotype might be modified during remission, which should be further investigated in longitudinal studies.
Literature
2.
go back to reference Daan S, Beersma DG, Borbély AA (1984) Timing of human sleep: recovery process gated by a circadian pacemaker. Am J Physiol 246:161–183 Daan S, Beersma DG, Borbély AA (1984) Timing of human sleep: recovery process gated by a circadian pacemaker. Am J Physiol 246:161–183
8.
19.
go back to reference Roenneberg T, Kuehnle T, Pramstaller PP et al (2004) A marker for the end of adolescence. Curr Biol 14:1038–1039CrossRef Roenneberg T, Kuehnle T, Pramstaller PP et al (2004) A marker for the end of adolescence. Curr Biol 14:1038–1039CrossRef
22.
go back to reference Horne JA, Ostberg O (1976) A self-assessment questionnaire to determine morningness–eveningness in human circadian rhythms. Int J Chronobiol 4:97–110PubMed Horne JA, Ostberg O (1976) A self-assessment questionnaire to determine morningness–eveningness in human circadian rhythms. Int J Chronobiol 4:97–110PubMed
25.
31.
go back to reference Drennan MD, Klauber MR, Kripke DF, Goyette LM (1991) The effects of depression and age on the Horne–Ostberg score. J Affect Disord 23:93–98CrossRefPubMed Drennan MD, Klauber MR, Kripke DF, Goyette LM (1991) The effects of depression and age on the Horne–Ostberg score. J Affect Disord 23:93–98CrossRefPubMed
41.
go back to reference Terman JS, Terman M, Lo ES, Cooper TB (2001) Circadian time of morning light administration and therapeutic response in winter depression. Arch Gen Psychiatry 58:69–75CrossRefPubMed Terman JS, Terman M, Lo ES, Cooper TB (2001) Circadian time of morning light administration and therapeutic response in winter depression. Arch Gen Psychiatry 58:69–75CrossRefPubMed
44.
go back to reference Gregory AM, Sadeh A (2015) Annual research review: sleep problems in childhood psychiatric disorders—a review of the latest science. J Child Psychol Psychiatry. doi:10.1111/jcpp.12469 Gregory AM, Sadeh A (2015) Annual research review: sleep problems in childhood psychiatric disorders—a review of the latest science. J Child Psychol Psychiatry. doi:10.​1111/​jcpp.​12469
47.
go back to reference Schneider S, Unnewehr S, Margraf J (2009) Kinder-DIPS—Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS—diagnostic interview for mental disorders in children and youths). Springer, Heidelberg Schneider S, Unnewehr S, Margraf J (2009) Kinder-DIPS—Diagnostisches Interview bei psychischen Störungen im Kindes- und Jugendalter (Kinder-DIPS—diagnostic interview for mental disorders in children and youths). Springer, Heidelberg
48.
go back to reference Neuschwander M, In-Albon T, Adornetto C et al (2013) Interrater-Reliabilität des Diagnostischen Interviews bei psychischen Störungen im Kindesund Jugendalter (Kinder-DIPS). Z Kinder Jugendpsychiatr Psychother 41:319–334. doi:10.1024/1422-4917/a000247 CrossRefPubMed Neuschwander M, In-Albon T, Adornetto C et al (2013) Interrater-Reliabilität des Diagnostischen Interviews bei psychischen Störungen im Kindesund Jugendalter (Kinder-DIPS). Z Kinder Jugendpsychiatr Psychother 41:319–334. doi:10.​1024/​1422-4917/​a000247 CrossRefPubMed
49.
go back to reference Beck AT, Steer RA, Brown GK (1996) Beck Depression inventory—second edition, manual. The Psychological Corporation, San Antonio Beck AT, Steer RA, Brown GK (1996) Beck Depression inventory—second edition, manual. The Psychological Corporation, San Antonio
51.
go back to reference Pietsch K, Hoyler A, Frühe B et al (2012) Früherkennung von Depressionen in der Pädiatrie: kriteriumsvalidität des Beck Depressions-Inventar Revison (BDI-II) und des Beck Depressions-Inventar-Fast Screen for Medical Patients (BDI-FS). PPmP Psychother Psychosom Medizinische Psychol. doi:10.1055/s-0032-1314869 Pietsch K, Hoyler A, Frühe B et al (2012) Früherkennung von Depressionen in der Pädiatrie: kriteriumsvalidität des Beck Depressions-Inventar Revison (BDI-II) und des Beck Depressions-Inventar-Fast Screen for Medical Patients (BDI-FS). PPmP Psychother Psychosom Medizinische Psychol. doi:10.​1055/​s-0032-1314869
52.
go back to reference Döpfner M, Görtz-Dorten A, Lehmkuhl G (2008) Diagnostik-System für Psychische Störungen im Kindes- und Jugendalter nach ICD-10 und DSM-IV, DISYPS-II. Huber Verlag, Bern Döpfner M, Görtz-Dorten A, Lehmkuhl G (2008) Diagnostik-System für Psychische Störungen im Kindes- und Jugendalter nach ICD-10 und DSM-IV, DISYPS-II. Huber Verlag, Bern
53.
go back to reference Buysse DJ, Reynolds CF, Monk TH et al (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213CrossRefPubMed Buysse DJ, Reynolds CF, Monk TH et al (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213CrossRefPubMed
54.
go back to reference Backhaus J, Junghanns K, Broocks A et al (2002) Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 53:737–740CrossRefPubMed Backhaus J, Junghanns K, Broocks A et al (2002) Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. J Psychosom Res 53:737–740CrossRefPubMed
55.
go back to reference Roenneberg T, Keller LK, Fischer D et al (2015) Human activity and rest in situ. Methods Enzymol 552:257–283CrossRefPubMed Roenneberg T, Keller LK, Fischer D et al (2015) Human activity and rest in situ. Methods Enzymol 552:257–283CrossRefPubMed
56.
go back to reference Vetter C, Wright KP, Winnebeck E, et al. Validation of the Munich Chronotype Questionnaire Vetter C, Wright KP, Winnebeck E, et al. Validation of the Munich Chronotype Questionnaire
71.
go back to reference Espiritu RC, Kripke DF, Ancoli-Israel S et al (1994) Low illumination experienced by San Diego adults: association with atypical depressive symptoms. Biol Psychiatry 35:403–407CrossRefPubMed Espiritu RC, Kripke DF, Ancoli-Israel S et al (1994) Low illumination experienced by San Diego adults: association with atypical depressive symptoms. Biol Psychiatry 35:403–407CrossRefPubMed
79.
go back to reference Probst JC, Laditka SB, Moore CG et al (2006) Rural-urban differences in depression prevalence: implications for family medicine. Fam Med 38:653–660PubMed Probst JC, Laditka SB, Moore CG et al (2006) Rural-urban differences in depression prevalence: implications for family medicine. Fam Med 38:653–660PubMed
80.
go back to reference Graw P, Recker S, Sand L (1999) Winter and summer outdoor light exposure in women with and without seasonal affective disorder. J Affect Disord 56:163–169CrossRefPubMed Graw P, Recker S, Sand L (1999) Winter and summer outdoor light exposure in women with and without seasonal affective disorder. J Affect Disord 56:163–169CrossRefPubMed
84.
go back to reference Tan ZL, Bao AM, Zhao GQ et al (2007) Effect of fluoxetine on circadian rhythm of melatonin in patients with major depressive disorder. Neuroendocrinol Lett 28:27–32 Tan ZL, Bao AM, Zhao GQ et al (2007) Effect of fluoxetine on circadian rhythm of melatonin in patients with major depressive disorder. Neuroendocrinol Lett 28:27–32
86.
go back to reference Center for Behavioral Health Statistics and Quality (2015) Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. In: HHS Publ. No. SMA 15-4927, NSDUH Ser. H-50. http://www.samhsa.gov/data/ Center for Behavioral Health Statistics and Quality (2015) Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. In: HHS Publ. No. SMA 15-4927, NSDUH Ser. H-50. http://​www.​samhsa.​gov/​data/​
Metadata
Title
Not later, but longer: sleep, chronotype and light exposure in adolescents with remitted depression compared to healthy controls
Authors
Lena Katharina Keller
Barbara Grünewald
Céline Vetter
Till Roenneberg
Gerd Schulte-Körne
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 10/2017
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-017-0977-z

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