Evidence for an association of serum melatonin concentrations with recognition and circadian preferences in patients with schizophrenia

  • Cigdem SahbazEmail author
  • Omer Faruk Özer
  • Ayse Kurtulmus
  • Ismet Kırpınar
  • Fikrettin Sahin
  • Sinan Guloksuz
Original Article


Melatonin, a neuro-differentiation factor, may play a role in the neurodevelopmental origins of schizophrenia. Cognitive impairment and decreased melatonin are reported in schizophrenia; however, the relationship between them remains unclear. We hypothesised that patients with schizophrenia would have lower concentrations of circulating melatonin than healthy controls and that melatonin levels would be associated with cognitive impairment. This study included 47 patients with schizophrenia and 40 healthy controls (HC). Serum melatonin concentrations were measured using the enzyme-linked immunosorbent assay. Positive and Negative Syndrome Scales (PANSS), The Morningness-Eveningness Questionnaire (MEQ), Pittsburgh Sleep Quality Index (PSQI), the Stroop and Oktem verbal memory processes (VMPT) tests were applied. Patients with schizophrenia had lower levels of melatonin compared to the HC group (p = 0.016), also after controlling for age, sex, and body mass index (BMI) (p = 0.024). In patients with schizophrenia, melatonin concentrations were associated with higher BMI (rho = 0.34, p = 0.01) and lower MEQ score (rho = −0.29, p = 0.035). The patient sample was split into low and high melatonin categories by using the median melatonin concentration in HC as the cut-off. Patients in the low melatonin group had poorer performance in VMPT-Recognition (p = 0.026) and Stroop-Colour Error (p = 0.032). Notwithstanding its limitations, the findings of this exploratory study suggest that decreased serum melatonin concentrations observed in schizophrenia might also be associated with cognitive impairment and circadian preferences. Future studies are required to investigate the role of melatonergic pathways in patients with schizophrenia.


Psychosis Melatonin Cognition Verbal memory Metabolic disturbance Circadian preferences 



This work is supported with the funding from the Yeditepe University Scientific Research and Projects Unit.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest in this work.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychiatryBezmialem Vakif UniversityIstanbulTurkey
  2. 2.Department of BiochemistryBezmialem Vakif UniversityIstanbulTurkey
  3. 3.Department of Bioengeneering and GeneticsYeditepe UniversityIstanbulTurkey
  4. 4.Department of Psychiatry and Neuropsychology, School for Mental Health and NeuroscienceMaastricht University Medical CentreMaastrichtthe Netherlands
  5. 5.Department of PsychiatryYale University School of MedicineNew HavenUSA

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