Decrease in Social Zeitgebers Is Associated With Worsened Delayed Sleep-Wake Phase Disorder: Findings During the Pandemic in Japan

Frontiers in Psychiatry

Psychiatry

Kentaro Matsui¹  Ayumi Tsuru¹  Rei Otsuki²  Takuya Yoshiike³  Kenichi Kuriyama³  Kentaro Nagao⁴  Tomohiro Utsumi⁵  Megumi Hazumi⁶  Naoko Ayabe⁷  Michio Fukumizu⁸ 

[1] Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Public Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Department of Regional Studies and Humanities, Faculty of Education and Human Studies, Akita University, Akita, Japan;Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology & Psychiatry, Tokyo, Japan;Segawa Memorial Neurological Clinic for Children, Tokyo, Japan;

关键词: delayed sleep-wake phase disorder;    coronavirus disease 2019;    COVID-19;    state of emergency;    Japan;    social zeitgeber;    bipolar disorder;    depression;   

DOI  :  10.3389/fpsyt.2022.898600

 received in 2022-03-17, accepted in 2022-05-17,  发布年份 2022

来源: Frontiers

【 摘 要 】

BackgroundDelay in sleep-wake rhythms was observed in the general population during the coronavirus disease 2019 (COVID-19) pandemic. Patients with delayed sleep-wake phase disorder (DSWPD) may have also experienced exacerbation of symptoms, but no studies have investigated this topic. In this study, we aimed to retrospectively examine the changes in symptoms of outpatients with DSWPD both before and during the pandemic and to identify the factors associated with the exacerbation of sleep-wake rhythms.MethodsWe included outpatients with DSWPD aged 16 years or older who visited the outpatient clinic due to sleep disorders between January and September 2020. Decreased social zeitgebers was defined as a reduction of 50% or more in the frequency of commuting to school or work during the COVID-19 pandemic. The severity of DSWPD was assessed using the clinical global impressions - severity of illness (CGI-S) at two points: before and during the pandemic. We defined the worsened, unchanged, and improved groups as those whose CGI-S scores worsened by at least one point, remained unchanged, and improved by at least one point, respectively. Multivariate logistic regression analysis was performed to determine the factors associated with worsened DSWPD symptoms.ResultsSixty patients with DSWPD were eligible for this study. Even before the pandemic, patients who were unemployed or did not attend school tended to show more severe DSWPD symptoms. During the pandemic, 27 patients belonged to the worsened group; 28 patients, unchanged group; and 5 patients, improved group. Decreased social zeitgebers (odds ratio [OR] = 6.668, 95% confidence interval [CI]: 1.653–26.891, p < 0.05) and comorbid mood disorders (OR = 8.876, 95% CI: 1.714–45.974, p < 0.05) showed independent significant associations with the worsening of DSWPD symptoms.ConclusionsDuring the pandemic, the symptoms of DSWPD tended to worsen. The obtained findings emphasize the importance of social zeitgebers, suggesting the need for external motivation in DSWPD treatment.

【 授权许可】

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Copyright © 2022 Otsuki, Matsui, Yoshiike, Nagao, Utsumi, Tsuru, Ayabe, Hazumi, Fukumizu and Kuriyama.