Adolescents at clinical-high risk for psychosis: Circadian rhythm disturbances predict worsened prognosis at 1-year follow-up

SCHIZOPHRENIA RESEARCH

卷:189

Article

Lunsford-Avery, Jessica R.¹  Brandao Goncalves, Bruno da Silva²  Brietzke, Elisa²  Bressan, Rodrigo A.³  Gadelha, Ary³  Auerbach, Randy P.^4,5  Mittal, Vijay A.^6,7,8,9 

[1] Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, 2608 Erwin Rd Suite 300, Durham, NC 27705 USA

[2] Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo, Brazil

[3] Univ Fed Sao Paulo, Dept Psychiat, LINC, Program Recognit & Intervent Individuals At Risk, Sao Paulo, Brazil

[4] Harvard Med Sch, Dept Psychiat, Boston, MA USA

[5] McLean Hosp, Ctr Depress Anxiety & Stress Res, Belmont, MA 02178 USA

[6] Northwestern Univ, Dept Psychol, Evanston, IL USA

[7] Northwestern Univ, Dept Psychiat, Evanston, IL USA

[8] Northwestern Univ, Dept Med Sociol Sci, Evanston, IL USA

[9] Northwestern Univ, Inst Policy Res, Evanston, IL USA

关键词: Circadian rhythm;    Actigraphy;    Prodromal;    Clinical high-risk;    Psychosis;    Schizophrenia;   

DOI  :  10.1016/j.schres.2017.01.051

来源: Elsevier

【 摘 要 】

Background: Individuals with psychotic disorders experience disruptions to both the sleep and circadian components of the sleep/wake cycle. Recent evidence has supported a role of sleep disturbances in emerging psychosis. However, less is known about how circadian rhythm disruptions may relate to psychosis symptoms and prognosis for adolescents with clinical high-risk (CHR) syndromes. The present study examines circadian rest/activity rhythms in CHR and healthy control (HC) youth to clarify the relationships among circadian rhythm disturbance, psychosis symptoms, psychosocial functioning, and the longitudinal course of illness. Methods: Thirty-four CHR and 32 HC participants were administered a baseline evaluation, which included clinical interviews, 5 days of actigraphy, and a sleep/activity diary. CHR (n = 29) participants were re-administered clinical interviews at a 1-year follow-up assessment. Results: Relative to HC, CHR youth exhibited more fragmented circadian rhythms and later onset of nocturnal rest. Circadian disturbances (fragmented rhythms, low daily activity) were associated with increased psychotic symptom severity among CHR participants at baseline. Circadian disruptions (lower daily activity, rhythms that were more fragmented and/or desynchronized with the light/dark cycle) also predicted severity of psychosis symptoms and psychosocial impairment at 1-year follow-up among CHR youth. Conclusions: Circadian rhythm disturbances may represent a potential vulnerability marker for emergence of psychosis, and thus, rest/activity rhythm stabilization has promise to inform early-identification and prevention/intervention strategies for CHR youth. Future studies with longer study designs are necessary to further examine circadian rhythms in the prodromal period and rates of conversion to psychosis among CHR teens. (C) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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