Abstract

Late diurnal preference has been linked to poorer mental health outcomes, but the understanding of the causal role of diurnal preference on mental health and wellbeing is currently limited. Late diurnal preference is often associated with circadian misalignment (a mismatch between the timing of the endogenous circadian system and behavioural rhythms), so that evening people live more frequently against their internal clock. This study aims to quantify the causal contribution of diurnal preference on mental health outcomes, including anxiety, depression and general wellbeing and test the hypothesis that more misaligned individuals have poorer mental health and wellbeing using an actigraphy-based measure of circadian misalignment. Multiple Mendelian Randomisation (MR) approaches were used to test causal pathways between diurnal preference and seven well-validated mental health and wellbeing outcomes in up to 451,025 individuals. In addition, observational analyses tested the association between a novel, objective measure of behavioural misalignment (Composite Phase Deviation, CPD) and seven mental health and wellbeing outcomes. Using genetic instruments identified in the largest GWAS for diurnal preference, we provide robust evidence that early diurnal preference is protective for depression and improves wellbeing. For example, using one-sample MR, a twofold higher genetic liability of morningness was associated with lower odds of depressive symptoms (OR: 0.92, 95% CI: 0.88, 0.97). It is possible that behavioural factors including circadian misalignment may contribute in the chronotype depression relationship, but further work is needed to confirm these findings.

Highlights

  • Using the Mendelian Randomisation (MR) power calculator we have demonstrated at p = 0.05 with our sample size we have >99% power [38]

  • Using one-sample MR, a twofold higher genetic liability of morningness was associated with lower odds of depressive symptoms (OR: 0.92, 95% CI: 0.88, 0.97)

  • Using genetic variants for diurnal preference, this study adds to the evidence base that being a morning person lowers the likelihood of depressive symptoms and major depression, improves wellbeing, and associates with less circadian misalignment, as assessed by objective, actigraphy measures of sleep variability that serve as a behavioural misalignment proxy

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Summary

Introduction

There is evidence that an individual’s diurnal preference is linked to disease development, including psychiatric disorders, with numerous cross-sectional studies reporting that early-type individuals have a lower risk of depressive symptoms, diagnosed depression and antidepressant use [3,4,5,6]. Additional studies have shown eveningness to associate with increased anxiety with some evidence that the relationship is present in women only [8, 9]. These results have the potential to be confounded and may be influenced by reverse causality

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