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

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

Author Lunsford-Avery, Jessica R. Google Scholar
Brandao Goncalves, Bruno da Silva Autor UNIFESP Google Scholar
Brietzke, Elisa Autor UNIFESP Google Scholar
Bressan, Rodrigo A. Autor UNIFESP Google Scholar
Gadelha, Ary Autor UNIFESP Google Scholar
Auerbach, Randy P. Google Scholar
Mittal, Vijay A. Google Scholar
Abstract 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.
Keywords Circadian rhythm
Actigraphy
Prodromal
Clinical high-risk
Psychosis
Schizophrenia
xmlui.dri2xhtml.METS-1.0.item-coverage Amsterdam
Language English
Sponsor National Institutes of Health
Grant number National Institutes of Health: RO1-MH-094650
National Institutes of Health: R21/R33-MH-103231
National Institutes of Health: K23-MH-108704
Date 2017
Published in Schizophrenia Research. Amsterdam, v. 189, p. 37-42, 2017.
ISSN 0920-9964 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Bv
Extent 37-42
Origin http://dx.doi.org/10.1016/j.schres.2017.01.051
Access rights Closed access
Type Article
Web of Science ID WOS:000416392400007
URI https://repositorio.unifesp.br/handle/11600/58253

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