Abstract
Drugs of abuse are widely known to worsen mental health problems, but this relationship may not be a simple causational one. Whether or not a person is susceptible to the negative effects of drugs of abuse may not only be determined by their addictive properties, but also the users’ chronotype, which determines their daily activity patterns. The present study investigates the relationship between chronotype, drug use and mental health problems in a cross-sectional community sample. Participants (n = 209) completed a selection of questionnaires online, including the Munich Chronotype Questionnaire, the Depression Anxiety Stress Scale, the Alcohol Use Disorder Identification Test, the Cannabis Use Disorder Identification Test and the Fagerström Test for Nicotine Dependence. We conducted multiple regression models to determine relationships between participants’ chronotype and their reported mental health symptoms and then estimated mediation models to investigate the extent to which their drug consumption accounted for the identified associations. Chronotype was significantly associated with participants’ overall mental health (β = 0.16, p = 0.022) and their anxiety levels (β = 0.18, p = 0.009) but not with levels of depression or stress. However, both relationships were fully mediated by participants’ overall drug consumption. Thus, late chronotypes, so-called “night owls”, not only use more drugs but consequently have an increased risk for developing anxiety and deteriorating mental health status. This group may be particularly vulnerable to the negative psychological effects of drugs. Our results point toward the importance of considering chronotype in designing preventative and therapeutic innovations, specifically for anxiety, which at present has been largely neglected.
Highlights
The relationship between drug use and mental health has been well established
Evening, chronotype was associated with higher anxiety and poorer overall mental health, suggesting that higher anxiety levels experienced by late chronotypes may have driven their significantly poorer overall mental health status
The combined consumption of tobacco, alcohol and cannabis, which is highly prevalent not just in the United Kingdom (UNODC, 2021), fully mediated both of these relationships. These results suggest that the association between late chronotype and poorer mental health is driven by increased overall drug consumption in late chronotypes, rather than chronotype itself
Summary
The relationship between drug use and mental health has been well established. This recent increase in mental health problems warrants further investigation into the relationship between drug use and mental health. Concurrent drug use is thought to reduce treatment efficacy by increasing drug cravings and drug intake, and has been linked with greater risk of mental health problems (McKee and Weinberger, 2013; Subbaraman and Kerr, 2015; Roche et al, 2019). The pattern of daily activity levels is determined by an individual’s circadian clock. The calibration of these circadian clocks vary from person to person, with a wide range of patterns throughout the population. Changes in working patterns and light exposure may have been influential in many peoples’ shift to a later chronotype during the pandemic
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