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The effect of chronotypes on follow-up outcomes of patients with substance use disorder

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Abstract

Substance use disorder (SUD) can have circadian characteristics and individuals with evening chronotype are more prone to addiction. In this study, the effect of chronotypes on the treatment outcomes of SUD was investigated. The study included 66 patients who were diagnosed with SUD according to DSM-5. Two clinical interviews were conducted at 6-month intervals, and remission/relapse status was evaluated at the second interview. The Structured Clinical Interview Form for DSM-IV Axis I Disorders (SCID-I), Addiction Profile Index Practitioner Form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburg Sleep Quality Index and Morningness-Eveningness Questionnaire (MEQ) were applied to the patients. MEQ scores of relapsed patients were found to be different in terms of eveningness than those in remission (45.62 ± 8.70 versus 49.75 ± 7.60, p = 0.045). As the craving and addiction profile index total scores (addiction severity) increased, eveningness chronotype scores also increased (r = − 0.387 and r = − 0.286, respectively). The mean scores of craving and BDI were higher in relapsed patients compared to those in remission (p = 0.003 and p = 0.015, respectively). Our results suggest that patients with SUD had a lower morningness chronotype than the general population; additionally, more relapsed patients had an eveningness chronotype. Thus, chronotypes may play a role in the onset, prevention, and treatment outcome of SUD.

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References

  1. Reinberg A, Ashkenazi I. Concepts in human biological rhythms. Dialogues Clin Neurosci. 2003;5:327–42.

    PubMed  PubMed Central  Google Scholar 

  2. Falcón E, McClung CA. A role for the circadian genes in drug addiction. Neuropharmacology. 2009;56:91–6.

    PubMed  Google Scholar 

  3. Baik JH. Dopamine signaling in reward-related behaviors. Front Neural Circuits. 2013;7:152.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Lüscher C. Drug-evoked synaptic plasticity causing addictive behavior. J Neurosci. 2013;33:17641–6.

    PubMed  PubMed Central  Google Scholar 

  5. Webb IC. Circadian rhythms and substance abuse: chronobiological considerations for the treatment of addiction. Curr Psychiatry Rep. 2017;19:12.

    PubMed  Google Scholar 

  6. McClung CA. Circadian genes, rhythms and the biology of mood disorders. Pharmacol Ther. 2007;114:222–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Adan A. Chronotype and personality factors in the daily consumption of alcohol and psychostimulants. Addiction (Abingdon, England). 1994;89:455–62.

    CAS  PubMed  Google Scholar 

  8. Giannotti F, Cortesi F, Sebastiani T, Ottaviano S. Circadian preference, sleep and daytime behaviour in adolescence. J Sleep Res. 2002;11:191–9.

    PubMed  Google Scholar 

  9. Prat G, Adan A. Influence of circadian typology on drug consumption, hazardous alcohol use, and hangover symptoms. Chronobiol Int. 2011;28:248–57.

    PubMed  Google Scholar 

  10. Wittmann M, Dinich J, Merrow M, Roenneberg T. Social jetlag: misalignment of biological and social time. Chronobiol Int. 2006;23:497–509.

    PubMed  Google Scholar 

  11. Wittmann M, Paulus M, Roenneberg T. Decreased psychological well-being in late “chronotypes” is mediated by smoking and alcohol consumption. Subst Use Misuse. 2010;45:15–30.

    PubMed  Google Scholar 

  12. Kervran C, Fatseas M, Serre F, Taillard J, Beltran V, Leboucher J, et al. Association between morningness/eveningness, addiction severity and psychiatric disorders among individuals with addictions. Psychiatry Res. 2015;229:1024–30.

    PubMed  Google Scholar 

  13. Teneggi V, Tiffany ST, Squassante L, Milleri S, Ziviani L, Bye A. Effect of sustained-release (SR) bupropion on craving and withdrawal in smokers deprived of cigarettes for 72 h. Psychopharmacology. 2005;183:1–12.

    CAS  PubMed  Google Scholar 

  14. Ren ZY, Zhang XL, Liu Y, Zhao LY, Shi J, Bao Y, et al. Diurnal variation in cue-induced responses among protracted abstinent heroin users. Pharmacol Biochem Behav. 2009;91:468–72.

    CAS  PubMed  Google Scholar 

  15. Peles E, Hetzroni T, Bar-Hamburger R, Adelson M, Schreiber S. Melatonin for perceived sleep disturbances associated with benzodiazepine withdrawal among patients in methadone maintenance treatment: a double-blind randomized clinical trial. Addiction (Abingdon, England). 2007;102:1947–53.

    PubMed  Google Scholar 

  16. Han J, Xu Y, Yu C-X, Shen J, Wei Y-M. Melatonin reverses the expression of morphine-induced conditioned place preference through its receptors within central nervous system in mice. Eur J Pharmacol. 2008;594:125–31.

    CAS  PubMed  Google Scholar 

  17. Raghavendra V, Kulkarni SK. Reversal of morphine tolerance and dependence by melatonin: possible role of central and peripheral benzodiazepine receptors. Brain Res. 1999;834:178–81.

    CAS  PubMed  Google Scholar 

  18. Lewis TF. Substance abuse and addiction treatment: practical application of counseling theory. London: Pearson Higher Ed; 2013.

    Google Scholar 

  19. Çorapçıoğlu A, Aydemir Ö, Yıldız M, Esen A, Köroğlu IV E. DSM-IV Eksen I Bozuklukları (SCID-I) için yapılandırılmış klinik görüşme, klinik versiyon. Ankara: Hekimler yayın birliği. 1999.

  20. Ögel K, Evren C, Karadağ F, Gürol T. Bağımlılık Profil İndeksi’nin (BAPİ) geliştirilmesi, geçerlik ve güvenilirliği. Turk Psikiyatri Derg. 2012;23:264–73.

    Google Scholar 

  21. Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi (A reliability and validity study of beck depression inventory in a university student sample). J Psychol. 1989;7:3–13.

    Google Scholar 

  22. Ulusoy M, Sahin NH, Erkmen H. The beck anxiety inventory: psychometric properties. J Cognit Psychother. 1998;12:163.

    Google Scholar 

  23. Agargun M. Pittsburgh uyku kalitesi indeksinin gecerligi ve guvenirligi. Turk Psikiyatri Dergisi. 1996;7:107–15.

    Google Scholar 

  24. Agargun MY, Cilli AS, Boysan M, Selvi Y, Gulec M, Kara H. Turkish version of morningness-eveningness questionnaire (MEQ). Sleep Hypn. 2007;9:16.

    Google Scholar 

  25. DSM-V. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Pub; 2013.

    Google Scholar 

  26. Cornelius JR, Maisto SA, Pollock NK, Martin CS, Salloum IM, Lynch KG, et al. Rapid relapse generally follows treatment for substance use disorders among adolescents. Addict Behav. 2003;28:381–6.

    PubMed  Google Scholar 

  27. Lopes-Rosa R, Kessler FP, Pianca TG, Guimaraes L, Ferronato P, Pagnussat E, et al. Predictors of early relapse among adolescent crack users. J Addict Dis. 2017;36:136–43.

    PubMed  Google Scholar 

  28. Fleury MJ, Djouini A, Huỳnh C, Tremblay J, Ferland F, Ménard JM, et al. Remission from substance use disorders: a systematic review and meta-analysis. Drug Alcohol Depend. 2016;168:293–306.

    PubMed  Google Scholar 

  29. Mattick RP, Breen C, Kimber J, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2014. https://doi.org/10.1002/14651858.CD002207.pub4.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Breese GR, Sinha R, Heilig M. Chronic alcohol neuroadaptation and stress contribute to susceptibility for alcohol craving and relapse. Pharmacol Ther. 2011;129:149–71.

    CAS  PubMed  Google Scholar 

  31. Drummond DC. Theories of drug craving, ancient and modern. Addiction (Abingdon, England). 2001;96:33–46.

    CAS  PubMed  Google Scholar 

  32. Festinger DS, Rubenstein DF, Marlowe DB, Platt JJ. Relapse: Contributing factors, causative models, and empirical considerations. In: Tims FM, Leukefeld CG, Platt JJ, editors. Relapse and recovery in addictions. Yale University Press; 2001. p. 122–42.

    Google Scholar 

  33. Tate SR, Wu J, McQuaid JR, Cummins K, Shriver C, Krenek M, et al. Comorbidity of substance dependence and depression: role of life stress and self-efficacy in sustaining abstinence. Psychol Addict Behav. 2008;22:47.

    PubMed  Google Scholar 

  34. Bachman JG, Freedman-Doan P, O’Malley PM, Schulenberg JE, Johnston LD. Revisiting marriage effects on substance use among young adults. Ann Arbor, MI: Institute for Social Research. 2008, (Monitoring the Future Occasional Paper No. 68).

  35. Scott KM, Wells JE, Angermeyer M, Brugha TS, Bromet E, Demyttenaere K, et al. Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders. Psychol Med. 2010;40:1495–505.

    CAS  PubMed  Google Scholar 

  36. Vignesh BT, Singh AK, Mohan SK, Murthy S, Joshi A. Association between socio-demographics and alcohol dependence among individuals living in an Indian setting. Glob J Health Sci. 2014;6:16–26.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Liu J, McDonough D, Wang Y, Zhou Y, Gao Z, Zhou C. Investigating the associations among drug dependents’ family function and exercise attitudes: marital status differences. Int J Environ Res Public Health. 2020;17:8111.

    PubMed  PubMed Central  Google Scholar 

  38. Habibi M, Darharaj M, Kelly A, Shahmiri H, Malekianjabali M, Kheirolomoom S. Drug use in soldiers: family and peer contextual associations. Subst Use Misuse. 2017;52:1357–63.

    PubMed  Google Scholar 

  39. Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011;41:15–28.

    PubMed  Google Scholar 

  40. Tantimonaco M, Ceci R, Sabatini S, Catani MV, Rossi A, Gasperi V, et al. Physical activity and the endocannabinoid system: an overview. Cell Mol Life Sci. 2014;71:2681–98.

    CAS  PubMed  Google Scholar 

  41. Smith MA, Lynch WJ. Exercise as a potential treatment for drug abuse: evidence from preclinical studies. Front Psychol. 2012;2:82.

    Google Scholar 

  42. Adan A, Natale V, Caci H. Cognitive strategies and circadian typology. In: Progress in circadian rhythm research. 2008. pp. 141–61.

  43. Adan A, Lachica J, Caci H, Natale V. Circadian typology and temperament and character personality dimensions. Chronobiol Int. 2010;27:181–93.

    PubMed  Google Scholar 

  44. Adan A, Natale V, Caci H, Prat G. Relationship between circadian typology and functional and dysfunctional impulsivity. Chronobiol Int. 2010;27:606–19.

    PubMed  Google Scholar 

  45. Teneggi V, Tiffany ST, Squassante L, Milleri S, Ziviani L, Bye A. Smokers deprived of cigarettes for 72 h: effect of nicotine patches on craving and withdrawal. Psychopharmacology. 2002;164:177–87.

    CAS  PubMed  Google Scholar 

  46. Webb IC, Lehman MN, Coolen LM. Diurnal and circadian regulation of reward-related neurophysiology and behavior. Physiol Behav. 2015;143:58–69.

    CAS  PubMed  Google Scholar 

  47. Lai HMX, Cleary M, Sitharthan T, Hunt GE. Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: a systematic review and meta-analysis. Drug Alcohol Depend. 2015;154:1–13.

    PubMed  Google Scholar 

  48. Decker KP, Peglow SL, Samples CR, Cunningham TD. Long-term outcomes after residential substance use treatment: relapse, morbidity, and mortality. Mil Med. 2017;182:e1589–95.

    PubMed  Google Scholar 

  49. Antypa N, Vogelzangs N, Meesters Y, Schoevers R, Penninx BW. Chronotype associations with depression and anxiety disorders in a large cohort study. Depress Anxiety. 2016;33:75–83.

    PubMed  Google Scholar 

  50. Hidalgo MP, Caumo W, Posser M, Coccaro SB, Camozzato AL, Chaves ML. Relationship between depressive mood and chronotype in healthy subjects. Psychiatry Clin Neurosci. 2009;63:283–90.

    PubMed  Google Scholar 

  51. Kitamura S, Hida A, Watanabe M, Enomoto M, Aritake-Okada S, Moriguchi Y, et al. Evening preference is related to the incidence of depressive states independent of sleep-wake conditions. Chronobiol Int. 2010;27:1797–812.

    PubMed  Google Scholar 

  52. Levandovski R, Dantas G, Fernandes LC, Caumo W, Torres I, Roenneberg T, et al. Depression scores associate with chronotype and social jetlag in a rural population. Chronobiol Int. 2011;28:771–8.

    PubMed  Google Scholar 

  53. Merikanto I, Kronholm E, Peltonen M, Laatikainen T, Vartiainen E, Partonen T. Circadian preference links to depression in general adult population. J Affect Disord. 2015;188:143–8.

    PubMed  Google Scholar 

  54. Park CI, An SK, Kim HW, Koh MJ, Namkoong K, Kang JI, et al. Relationships between chronotypes and affective temperaments in healthy young adults. J Affect Disord. 2015;175:256–9.

    PubMed  Google Scholar 

  55. Fares S, Hermens DF, Naismith SL, White D, Hickie IB, Robillard R. Clinical correlates of chronotypes in young persons with mental disorders. Chronobiol Int. 2015;32:1183–91.

    PubMed  Google Scholar 

  56. Gaspar-Barba E, Calati R, Cruz-Fuentes CS, Ontiveros-Uribe MP, Natale V, De Ronchi D, et al. Depressive symptomatology is influenced by chronotypes. J Affect Disord. 2009;119:100–6.

    PubMed  Google Scholar 

  57. Lemoine P, Zawieja P, Ohayon MM. Associations between morningness/eveningness and psychopathology: an epidemiological survey in three in-patient psychiatric clinics. J Psychiatr Res. 2013;47:1095–8.

    PubMed  Google Scholar 

  58. Broms U, Pitkäniemi J, Bäckmand H, Heikkilä K, Koskenvuo M, Peltonen M, et al. Long-term consistency of diurnal-type preferences among men. Chronobiol Int. 2014;31:182–8.

    PubMed  Google Scholar 

  59. Taillard J, Philip P, Chastang JF, Bioulac B. Validation of Horne and Ostberg morningness-eveningness questionnaire in a middle-aged population of French workers. J Biol Rhythms. 2004;19:76–86.

    PubMed  Google Scholar 

  60. Lee JH, Kim IS, Kim SJ, Wang W, Duffy JF. Change in individual chronotype over a lifetime: a retrospective study. Sleep Med Res. 2011;2:48–53.

    Google Scholar 

  61. Rogers HL, Reilly SM. A survey of the health experiences of international business travelers: part one—physiological aspects. AAOHN J. 2002;50:449–59.

    PubMed  Google Scholar 

  62. Trinkoff AM, Storr CL. Work schedule characteristics and substance use in nurses. Am J Ind Med. 1998;34:266–71.

    CAS  PubMed  Google Scholar 

  63. Perreau-Lenz S, Vengeliene V, Noori HR, Merlo-Pich EV, Corsi MA, Corti C, et al. Inhibition of the casein-kinase-1-epsilon/delta prevents relapse-like alcohol drinking. Neuropsychopharmacology. 2012;37:2121.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Kantermann T, Juda M, Merrow M, Roenneberg T. The human circadian clock’s seasonal adjustment is disrupted by daylight saving time. Curr Biol. 2007;17:1996–2000.

    CAS  PubMed  Google Scholar 

  65. Lahti TA, Leppämäki S, Lönnqvist J, Partonen T. Transitions into and out of daylight saving time compromise sleep and the rest-activity cycles. BMC Physiol. 2008;8:1–6.

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, Duzce Ataturk State Hospital, Duzce, Turkey

    Ozlem Akcay Ciner

  2. Department of Psychiatry, Medical Faculty, Sakarya University, Sakarya, Turkey

    Ali Savas Cilli & Ahmet Bulent Yazici

  3. Department of Psychiatry, Meram Medical Faculty, Necmettin Erbakan University, Yunus Emre Mah. Beyşehir Cad. No: 281, Meram, 42090, Konya, Turkey

    Hasan Bakay & Şakir Gica

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  1. Ozlem Akcay Ciner
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  2. Ali Savas Cilli
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  4. Hasan Bakay
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  5. Şakir Gica
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Contributions

Conceptualization: OAC, ASC; Methodology: OAC, ABY, HB, ŞG; Formal analysis and investigation: OAC, ASC, ABY; Writing—original draft preparation: OAC, ASC; Writing—review and editing: ABY, HB, ŞG; Resources: OAC, ASC; Supervision: ABY, HB, ŞG.

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Correspondence to Hasan Bakay.

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Ethical approval for the study was obtained from the Ethics Committee of Faculty of Medicine of Sakarya University. Completed voluntary informed consent forms were obtained from the patients prior to the start of the study.

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Ciner, O.A., Cilli, A.S., Yazici, A.B. et al. The effect of chronotypes on follow-up outcomes of patients with substance use disorder. Sleep Biol. Rhythms 22, 247–258 (2024). https://doi.org/10.1007/s41105-023-00496-8

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