Report from a randomized control trial

Improved alignment between circadian biology and sleep–wake behavior as a mechanism of depression symptom improvement in evening‐type adolescents with depressive symptoms

Bibliographic Data

ID21344878
AuthorsLauren D Asarnow (0000-0003-4989-2524, Department of Psychiatry and Behavioral Science University of California, San Francisco San Francisco California USA, corresponding author), Adriane M Soehner (0000-0003-3172-1815, University of Pittsburgh), Adriane Soehner (Department of Psychiatry and Behavioral Science University of Pittsburgh Pittsburgh Pennsylvania USA), Emily A Dolsen (0000-0002-2770-2796, San Francisco VA Medical Center), Emily Dolsen (Department of Psychiatry and Behavioral Science University of California, San Francisco San Francisco California USA), L Dong (0000-0002-1075-9374, RAND Corporation), Allison G Harvey (0000-0002-8609-0005, Department of Psychology University of California, Berkeley Berkeley California USA)
Year2023
Volume64
Issue12
Pages1652-1664
Publication date2023-12-01
Open AccessYes
TypeARTICLE
VenueJournal of Child Psychology and Psychiatry (JOURNAL)
Journal identifiersISSN: 0021-9630 • E-ISSN: 1469-7610
PublisherWiley (PUBLISHER • GB)
DOI10.1111/jcpp.13880
PMID37589403
OpenAlexW4385897661
LanguageEN
Citations received2
References cited55

STUDY OBJECTIVES: An evening circadian preference is common among adolescents. It is characterized by a behavioral predilection for later sleep and wake timing and is associated with higher rates of Major Depressive Disorder (MDD). The present study aims to (a) test the effectiveness of a cognitive behavioral sleep intervention (Transdiagnostic Sleep and Circadian Intervention; TranS-C) in a sample of adolescents with an evening circadian preference and clinically significant depressive symptoms and (b) evaluate improved alignment between circadian biology and sleep-wake behavior as a potential mechanism in the relationship between sleep and depression symptom improvement. METHODS: Adolescents with an evening circadian preference and clinically significant depressive symptoms were randomized to receive TranS-C (n = 24) or a psychoeducation condition (PE; n = 18). Alignment between circadian biology and sleep-wake behavior was measured using objective biological measurement. Measures of sleep and circadian rhythm were taken at pre- and posttreatment, and depression symptoms were measured at pre- and posttreatment and 6- and 12-month follow-up. RESULTS: Mixed effects modeling revealed that compared with an active control condition, TranS-C resulted in a significant reduction in MDD severity at 12-month follow-up. A MacArthur mediation analysis conducted to explore alignment between circadian biology and sleep-wake behavior as a mediator of depression severity reduction through 12-month follow-up revealed a significant interaction between change in alignment between circadian biology and sleep-wake behavior and treatment arm, indicating that improved alignment between circadian biology and sleep-wake behavior at posttreatment was associated with improvements in depression outcomes at 12-month follow-up under the treatment condition. CONCLUSIONS: These results provide novel evidence for improved alignment between circadian biology and sleep-wake behavior as a specific mechanism of depression improvement, provide key clues into the complex relationship between sleep and depression, and have significant clinical implications for adolescents with depression

Chronotype · Circadian rhythm · Depression (economics) · Evening · Major depressive disorder · Mood · Randomized controlled trial · Circadian rhythm and melatonin · Clinical Psychology · Internal Medicine · Medicine · Neuroscience · Psychology · Sleep and related disorders · Sleep and Wakefulness Research

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