Time of Day Matters: An Exploratory Assessment of Chronotype in a Forensic Psychiatric Hospital.

Kimberly D Belfry,Scott H Deibel,Nathan J Kolla

doi:10.3389/fpsyt.2020.550597

Abstract

A growing body of evidence links the late chronotype to mental illness, aggression, and aversive personality traits. However, much of what we know about these associations is based on healthy cohorts, and it is unclear how individuals with high levels of aggression, including forensic psychiatric populations, but not offenders, are affected. The present study aimed to measure chronotype in a forensic psychiatric inpatient population, evaluate the impact of diagnosis, and identify any interactive relationships between chronotype, diagnosis, aggression, and dark triad traits. Subjects completed the reduced Morningness–Eveningness Questionnaire (rMEQ), Munich ChronoType Questionnaire (MCTQ), Pittsburgh Sleep Quality Index (PSQI), Buss Perry Aggression Questionnaire–Short Form (BPAQ-SF), and Short Dark Triad Questionnaire (SD3). We sampled 55 forensic psychiatric patients (52 males) between the ages of 23 and 73 years (mean ± SD: 39.6 ± 14.3 years). Among the patients sampled, 25% were evening types and 36% were morning types. Eveningness was greater in patients with a personality disorder; however, no chronotype differences were found for psychosis patients. Patients without psychosis had a positive association between anger and eveningness, as well as between hostility and eveningness. For subjects with a substance use disorder, morningness was positively associated with narcissism. Conversely, an association between eveningness and greater narcissism was identified in patients who did not have a substance use disorder. These findings suggest that, compared to the general population, evening types are more prevalent in forensic psychiatric populations, with the strongest preference among patients diagnosed with a personality disorder. No differences in chronotype were identified for psychosis patients, which may be related to anti-psychotic medication dosing. Given the sex distribution of the sample, these findings may be more relevant to male populations.

Highlights

Sunrise and sunset are some of the most salient environmental cues that influence an organism’s behavior [1]
RMEQ, reduced Morningness–Eveningness Questionnaire; MCTQ, Munich ChronoType Questionnaire; MSW, Mid-sleep on work days; MSF, Mid-sleep on free days; MSFSC, Mid-sleep on free days corrected for sleep debt on work days; PSQI, Pittsburgh Sleep Quality Index; NA, Not available, study participant was an extreme outlier and MCTQ and PSQI data were excluded from the analysis
Of the 43 subjects diagnosed with a psychotic disorder, 13 had a comorbid personality disorder, 11 of which had a substance use disorder

Summary

Introduction

Sunrise and sunset are some of the most salient environmental cues that influence an organism’s behavior [1]. Circadian rhythms allow organisms to adjust their physiology and behavior so that they are synchronized with the environment [1]. Humans are very active during the day and less so during the night, there is variation in when one prefers to go to bed, wake up, and perform cognitive and physical activities. Chronotype refers to the timing of these preferences in relation to sunrise and sunset [2]. Chronotypes are early to rise and sleep, with a preference for cognitive and physical activities in the morning. Late chronotypes are late to rise and sleep, with a preference for cognitive and physical activities later in the day

Objectives

Results

Conclusion