763 Indicators of delayed circadian rhythms are associated with OCD symptoms

Abstract

Abstract Introduction Increasing evidence implicates delayed circadian rhythms in obsessive-compulsive disorder (OCD). Indeed, eveningness prospectively predicts increased OCD symptoms (Cox, Tuck, & Olatunji, 2018), and several studies have highlighted a link between later bedtimes and OCD symptoms (e.g., Nota et al., 2020; Schubert, Stewart, & Coles, 2019). Notably, no study to date has examined the associations between midsleep or delayed sleep-wake phase disorder (DSWPD) status and OCD symptom severity. The present study sought to address these gaps in the literature by utilizing a multimethod approach to characterize the associations between indicators of delayed circadian rhythms and OCD. Methods Adults with (n=57) and without (n=20) elevated OCD symptoms were recruited. Of those with elevated symptoms, 20 met criteria for OCD. Of those who did not meet criteria for OCD, 29 were identified as healthy controls (no diagnoses). On day 1, participants were administered the MINI International Neuropsychiatric Interview (Sheehan et al., 1988) to determine diagnostic status, the Diagnostic Interview for Sleep Patterns and Disorders (Merikangas et al., 2014) to diagnose DSWPD, and the Morningness-Eveningness Questionnaire (Horne & Ostberg, 1976) to measure eveningness tendency. Participants then completed 7 days of sleep monitoring with the Consensus Sleep Diary (CSD; Carney et al., 2012) to measure midsleep. On day 9, participants completed the Obsessive-Compulsive Inventory-Revised (Foa et al., 2002) to measure OCD symptom severity. Results Results indicated a significant relationship between OCD and DSWPD status, X2(2, n=49)=13.91, p<.01, such that 40% of those with OCD also met criteria for DSWPD, relative to 0% of healthy controls. Similarly, those with OCD reported significantly increased eveningness tendency (M=40.60, SD=9.54) compared to healthy controls (M=53.66, SD=13.15), t(47)=3.80, p<.01, d=1.14. Among those with elevated OCD symptoms, there was trend level increase in OCD symptom severity between those with DSWPD (M=25.45, SD=11.23) and without DSWPD (M=19.44, SD=9.80), t(52)=1.76, p=.08, d=0.57. Finally, across the whole sample, later midsleep significantly predicted increased OCD symptoms (b=.27, p<.05). Conclusion These results replicate and extend the growing literature on delayed circadian rhythms in OCD and suggest that circadian dysregulation may represent a novel target for treatment. Support (if any):