How do stress, sleep quality, and chronotype associate with clinically significant depressive symptoms? A study of young male military recruits in compulsory service

Abstract

Objective: Although studies have shown an association between poor sleep and chronotype with psychiatric problems in young adults, few have focused on identifying multiple concomitant risk factors. Methods: We assessed depressive symptoms (Beck Depression Inventory [BDI]), circadian typology (Morningness-Eveningness Questionnaire [MEQ]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), perceived stress (Perceived Stress Scale [PSS]), social rhythm (Social Rhythm Metrics [SRM]), and salivary cortisol (morning, evening and night, n=37) in 236 men (all 18 years old). Separate analyses were conducted to understand how each PSQI domain was associated with depressive symptoms. Results: Depressive symptoms were more prevalent in individuals with higher perceived stress (prevalence ratio [PR] = 6.429, p o 0.001), evening types (PR = 2.58, p o 0.001) and poor sleepers (PR = 1.808, p = 0.046). Multivariate modeling showed that these three variables were independently associated with depressive symptoms (all p o 0.05). The PSQI items subjective sleep quality and sleep disturbances were significantly more prevalent in individuals with depressive symptoms (PR = 2.210, p = 0.009 and PR = 2.198, p = 0.008). Lower levels of morning cortisol were significantly associated with higher depressive scores (r =-0.335; p = 0.043). Conclusion: It is important to evaluate multiple factors related to sleep and chronotype in youth depression studies, since this can provide important tools for comprehending and managing mental health problems.

Circadian Characteristics in Patients under Treatment for Substance Use Disorders and Severe Mental Illness (Schizophrenia, Major Depression and Bipolar Disorder)

“…The patients under outpatient treatment, however, showed less daytime activation (minimum, higher L10 value and mesor) and a more evening pattern (later acrophase) compared to patients in residential facilities. Overall, these observations reveal a low contrast in their day-to-day life [ 77 ] in consistency with previous observations made in MDD+ [ 15 ] and in depression without SUD [ 44 ]. Therefore, it is emphasized that the treatment of dual patients, regardless of their SMI comorbidity, should promote rhythmic organization, physical activity in the open air and stable feeding times to maximize a good circadian expression and a morning pattern [ 14 , 55 , 78 ].…”

Poor sleep quality associates with self‐reported psychiatric and cardiometabolic symptoms independently of sleep timing patterns in a large sample of rural and urban workers

“…The association between psychiatric self‐reported symptoms and sleep quality is an expected finding and replicates similar results recently published (Hertenstein et al, ; Tonon et al, ). Considering the components included in the PSQI score—subjective sleep quality (1), sleep disturbances (5), use of sleep medication (6), and daytime dysfunction (7), all of them showed significantly higher proportions of psychiatric self‐reported symptoms in poor sleep quality (scores 2 and 3) when compared with good sleep quality (scores 0 and 1) groups (Figure ).…”

Sleep Characteristics and Risk Factors of Korean Esports Athletes: An Exploratory Study

“…However, the findings that the average depression score exceeded the clinical cut-off value of 16 and that the rate of the high-risk group for depression reached 64.7% suggests a high possibility that depression worsened the subjective sleep quality of esports athletes. These high levels of depression are also related to the delayed sleep phase [33]. In a study that examined the relationships among sleep quality, circadian pattern, and emotion in 236 young adults aged approximately 18 years, participants with an evening phase complained of more depressive symptoms [33].…”

“…These high levels of depression are also related to the delayed sleep phase [33]. In a study that examined the relationships among sleep quality, circadian pattern, and emotion in 236 young adults aged approximately 18 years, participants with an evening phase complained of more depressive symptoms [33].…”