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

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

doi:10.3390/jcm10194388

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

J Clin Med. 2021 Sep 25;10(19):4388. doi: 10.3390/jcm10194388.

Authors

Ana Belén Serrano-Serrano¹, Julia E Marquez-Arrico¹, José Francisco Navarro², Antonio Martinez-Nicolas^{3

4

5}, Ana Adan^{1

6}

Affiliations

¹ Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebrón 171, 08035 Barcelona, Spain.
² Department of Psychobiology, Campus de Teatinos s/n, School of Psychology, University of Málaga, 29071 Málaga, Spain.
³ Chronobiology Lab, Department of Physiology, Mare Nostrum Campus, IMIB-Arrixaca, IUIE, College of Biology, University of Murcia, 30100 Murcia, Spain.
⁴ Human Physiology Area, Faculty of Sport Sciences, University of Murcia, Santiago de la Ribera-San Javier, 30720 Murcia, Spain.
⁵ Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain.
⁶ Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain.

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.

Keywords: bipolar disorder; chronobiology; circadian rhythm; distal skin temperature; dual disorders; major depressive disorder; schizophrenia; substance use disorders.