Circadian Characteristics in Patients under Treatment for Substance Use Disorders and Severe Mental Illness (Schizophrenia, Major Depression and Bipolar Disorder).

Ana Belén Serrano-Serrano,Antonio Martinez-Nicolas,Julia E Marquez-Arrico,Ana Adan,José Francisco Navarro

doi:10.3390/jcm10194388

Ana Belén Serrano-Serrano, Antonio Martinez-Nicolas + Show 3 more

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https://doi.org/10.3390/jcm10194388

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Abstract

Dual disorders (substance use and mental illness comorbidity) are a condition that has been strongly associated with severe symptomatology and clinical complications. The study of circadian characteristics in patients with Severe Mental Illness or Substance Use Disorder (SUD) has shown that such variables are related with mood symptoms and worse recovery. In absence of studies about circadian characteristics in patients with dual disorders we examined a sample of 114 male participants with SUD and comorbid Schizophrenia (SZ+; n = 38), Bipolar Disorder (BD+; n = 36) and Major Depressive Disorder (MDD+; n = 40). The possible differences in the sample of patients according to their psychiatric diagnosis, circadian functioning with recordings of distal skin temperature during 48 h (Thermochron iButton®), circadian typology and sleep-wake schedules were explored. MDD+ patients were more morning-type, while SZ+ and BD+ had an intermediate-type; the morning-type was more frequent among participants under inpatient SUD treatment. SZ+ patients had the highest amount of sleeping hours, lowest arousal and highest drowsiness followed by BD+ and MDD+, respectively. These observed differences suggest that treatment for patients with dual disorders could include chronobiological strategies to help them synchronize patterns with the day-light cycle, since morning-type is associated with better outcomes and recovery.

Highlights

The groups showed significant differences in the sociodemographic variables studied such as age (p = 0.009), marital status (p = 0.011), number of children (p = 0.002), family situation (p = 0.001), employment status (p = 0.001) and years of study (p = 0.026)
This study aims to analyze differences in circadian rhythmicity in patients under the SZ+ group exhibited a negative relationship for the values of mesor and L10, and t treatment with Substance Use Disorder (SUD) attending to comorbid Severe Mental Illness (SMI), as well as its possible relationship with
SMI, as well as the relationship with sociodemographic, clinical variables and treatment modality received for the SUD

Summary

Introduction

High prevalence and clinical and functional implications of dual disorders, in recent years interest in its study has increased with the aim of improving both the detection and the therapeutic approach [2,3,4]. Rhythmic alterations commonly observed in patients with SUD are amplitude reduction and phase delay, which in severe cases can lead to chronodisruption or disappearance of rhythmicity [8]. This affectation is related both to the type of substance used and to the person’s metabolism and tolerance (i.e., sensitivity to reward) [11]

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