Can chronotype function as predictor of a persistent course of depressive and anxiety disorder?

Druiven, S.J.M.; Knapen, S.E.; Penninx, B.W.J.H.; Antypa, N.; Schoevers, R.A.; Riese, H.; Meesters, Y.

doi:doi:10.1016/j.jad.2018.08.064

Background: The role of chronotype, the individual timing of sleep/activity, has been studied in relation to
depressive and anxiety disorders. A cross-sectional association between a depressive episode and evening-type
has been identified. However, until now the predicting capacity of chronotype concerning persistence of psy-
chiatric disorders remains unclear. Our aim is to examine whether a later chronotype in patients with a de-
pressive and/or anxiety disorder can serve as a predictor of a persistent course.
Methods: A subsample of patients with a depressive and/or anxiety disorder diagnosis and chronotype data of
the longitudinal Netherlands Study of Depression and Anxiety (NESDA) was used. Diagnosis of depressive and
anxiety disorders (1-month DSM-IV based diagnosis) were determined at baseline (n = 505). From this group
persistence was determined at 2-year (FU2) (persistent course: n = 248, non-persistent course: n = 208) and 4-
year follow-up ...Show moreBackground: The role of chronotype, the individual timing of sleep/activity, has been studied in relation to
depressive and anxiety disorders. A cross-sectional association between a depressive episode and evening-type
has been identified. However, until now the predicting capacity of chronotype concerning persistence of psy-
chiatric disorders remains unclear. Our aim is to examine whether a later chronotype in patients with a de-
pressive and/or anxiety disorder can serve as a predictor of a persistent course.
Methods: A subsample of patients with a depressive and/or anxiety disorder diagnosis and chronotype data of
the longitudinal Netherlands Study of Depression and Anxiety (NESDA) was used. Diagnosis of depressive and
anxiety disorders (1-month DSM-IV based diagnosis) were determined at baseline (n = 505). From this group
persistence was determined at 2-year (FU2) (persistent course: n = 248, non-persistent course: n = 208) and 4-
year follow-up (FU4) (persistent course: n = 151, non-persistent course: n = 264). Chronotype was assessed at
baseline with the Munich Chronotype Questionnaire.
Results: A later chronotype did not predict a persistent course of depressive and/or anxiety disorder at FU2 (OR
(95% CI) = 0.99 (0.83–1.19), P = 0.92) or at FU4 (OR (95% CI) = 0.94 (0.77–1.15), P = 0.57).
Limitations: Persistence was defined as having a diagnosis of depressive and/or anxiety disorder at the two-year
and four-year follow-up, patients may have remitted and relapsed between assessments.
Conclusion: Chronotype, measured as actual sleep timing, of patients with a depressive or anxiety disorder did
not predict a persistent course which suggests it might be unsuitable as predictive tool in clinical settings.
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Can chronotype function as predictor of a persistent course of depressive and anxiety disorder?