The role of circadian rhythm preference in the onset of depression in adolescents

Abstract

Background:Evening Chronotype (ET) is associated with Major Depressive Disorder (MDD) and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Arginine vasopressin (AVP), in conjunction with CRH, promotes the production of adrenocorticotropic hormone (ACTH), thereby influencing cortisol (COR) secretion. Objective:To explore biomarkers related to circadian rhythm preference in adolescent patients with depression and to investigate the association between evening chronotype and copeptin levels in adolescents. Methods:A case-control study was conducted, including 99 adolescent patients diagnosed with depression according to DSM-5 criteria. They were divided into an evening chronotype group (MDD-ET+,n=61) and a non-evening chronotype group (MDD-ET-, n=38) based on the Morning and Evening Questionnaire 5 (MEQ-5). An age-matched control group of 57 individuals was also selected and divided into an evening chronotype group (HC-ET+, n=30) and a non-evening chronotype group (HC-ET-, n=27) based on the MEQ-5 questionnaire. Biological markers such as cortisol (COR), adrenocorticotropic hormone (ACTH), and interleukin-6 (IL-6) were measured using electrochemiluminescence, C-reactive protein (CRP) was measured using immunoturbidimetry, and copeptin was measured using competitive ELISA. Results:1.The MDD-ET+ group had higher scores for depression, anxiety, and levels of inflammatory factors IL-6 and CRP compared to the MDD-ET- group. No significant difference in copeptin levels was found between the MDD-ET+ and MDD-ET- groups. 2.IL-6 might be a risk factor for evening chronotype depression (P<0.05). In a 2x2 ANCOVA, MDD showed a significant main effect on copeptin levels (F=4.79; P=0.030), but ET did not (F=1.53; P=0.083), nor was there a significant interaction between MDD and ET (F=1.37; P=0.243). Conclusion:1.Evening chronotype preference is related to the severity of depressive symptoms in adolescents, with IL-6 and CRP potentially mediating the worsening of depression.