The baseline detection rates for chronotypes among 154 patients with were 14.93% evening types, 56.5% intermediate types, and 28.57% morning types.
Patients exhibited significant reductions in depression scores at weeks 2, 4, 8, and 12 after treatment compared to baseline.
Changes in chronotype post-treatment were associated with gender, age, body mass index, first-episode depression, medication type, and baseline scores.
Logistic regression identified medication type, baseline morningness-eveningness questionnaire scores, and baseline pleasure scores as risk factors for improvement in .
Effective antidepressant therapy may normalize circadian rhythm disturbances in patients with major depressive disorder.
Simplified
OBJECTIVE: To investigate the circadian rhythms of patients with (MDD) pre-treatment and post-treatment to analyse possible influencing factors.
METHODS: In this study, we recruited 154 patients in the acute phase of MDD from 10 psychiatric centers in the province. The patients were divided into a morning chronotype group (16-41 points), an intermediate chronotype group (42-58 points) and an evening chronotype group (59-86 points), according to the total scores obtained from the morningness-eveningness questionnaire (MEQ). They were treated randomly with antidepressants, either selective serotonin reuptake inhibitors or agomelatine, for 12 weeks and were evaluated using the MEQ, the 17-item Hamilton Depression Rating Scale (HAMD-17), the Hamilton anxiety scale, the Snaith-Hamilton pleasure scale (SHAPS), the multidimensional fatigue inventory (MFI-20) and the Pittsburgh sleep quality index at the baseline and then at 2, 4, 8 and 12 weeks. The results were analysed by Logistic regression analysis and repeated-measures analysis of variance.
RESULTS: The baseline detection rates for the evening, intermediate and morning types were 14.93%, 56.5% and 28.57%, respectively. HAMD-17 scores were significantly lower at weeks 2, 4, 8, and 12 after treatment in patients with different concurrent phenotypes compared with those before treatment (P<0.05). There were significant differences in gender, age, body mass index, whether depression was first-episode, type of medication, baseline-MEQ and baseline-SHAPS in the chronotype change group compared with the post-treatment chronotype unchanged group (p<0.05). Logistic regression analysis showed that medication type (P=0.047), baseline MEQ (P=0.001) and baseline SHAPS (P=0.001) were risk factors for improvement in after treatment for depression.
CONCLUSION: Circadian rhythm disturbances can be adjusted to a normal pattern with effective antidepressant therapy. The medication type, baseline MEQ and baseline SHAPS scores were the influencing factors for the recovery of circadian rhythm disorders.
