The relationship between chronotype and depressive symptoms: a meta-analysis
Abstract
Background Expanding our understanding of the factors that influence depression is crucial for prognosis and treatment. In light of increasing evidence of an association between disrupted circadian rhythms and affective symptoms, a meta-analysis was used to examine the relationship between an eveningness chronotype and depression. Methods Electronic searches of the PsycINFO, Medline, Scopus, and Google Scholar databases were conducted in February 2016. Relevant reviews, related journals, and reference lists were manually searched. Statistical data were reported or transformed to a Fisher's z correlational coefficient for effect size analysis. Results Data from 36 studies (n =15734) met the inclusion criteria and were analysed under a random effects model. Nearly all included studies utilised the Composite Scale of Morningness (CSM) or the Morningness-Eveningness Questionnaire (MEQ) as a measure of chronotype. Overall effect size from 58 effect sizes was small (z=-.20; 95% CI: -.18 to -.23). Effect sizes based on the CSM were significantly larger than those based on the MEQ. There was no evidence of publication bias. Limitations The number of studies comparing different mood disorders or the potential moderating effects of gender and age were too few to draw conclusions regarding their respective effect sizes. Future research should utilise longitudinal designs to draw causal inferences on the directionality of this relationship. Conclusions Findings from this meta-analysis in…
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Peripheral methylation may reflect not only illness severity but also chronicity and recurrence risk.
“suggesting that peripheral methylation may reflect not only illness severity but also chronicity and recurrence risk (Sorlí et al., 2024; Norbury, 2021; Au and Reece, 2017)”
From Histone modifications and depression: epigenetic mechanisms, therapeutic targets, and translational outlook (2026) · cites this paper as Au and Reece, 2017
Depressive symptoms-particularly in women-are associated with faster biological aging as indicated by measures such as the DunedinPACE clock.
“measures such as the DunedinPACE clock indicate that depressive symptoms—particularly in women—are associated with faster biological aging”
From Histone modifications and depression: epigenetic mechanisms, therapeutic targets, and translational outlook (2026) · cites this paper as Au and Reece, 2017
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“…et al. 2019; Díaz-Morales et al. 2017), it may be found to be important in the previously established relationships between morningness-eveningness and well-being or distress/disorder (e.g., Au and Reece 2017; Bakotic et al. 2017; Biss and Hasher 2012; Suh et al. 2017; Taylor and Hasler 2018).”
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“ingness predisposes individuals to an increased risk of depression, (ii) depressive symptomology influences individuals chronotype or (iii) the relationship between depression and chronotype is bi-directional (Au and Reece 2017; Kivelä et al. 2018).”
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“It is also associated with mental illness (e.g., depression) (30, 31).”
BackgroundGomes, S. S., von Schantz, M., & Leocadio-Miguel, M. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.01.002 · Cited by 27 · see citing works
Cabrera, J. R., Garaulet, M., Torres, J., Díaz, J. F. A., Navarro, G. M. Q., Piedra, L., Peńa, J., Cantalejo, F. R., Rangel-Zúñiga, O., Yubero-Serrano, E., et al. (2021) · Translational Research: The Journal of Laboratory and Clinical Medicine · doi:10.1016/j.trsl.2021.11.001 · Cited by 27 · see citing works
Çalıyurt, O. (2017) · Balkan Medical Journal · doi:10.4274/balkanmedj.2017.1280 · Cited by 27 · see citing works
“In particular, night-oriented chronotypes revealed increased symptoms of depression and mood disorders (33).”
BackgroundGeorge, S., Kunkels, Y., Booij, S., & Wichers, M. (2021) · Scientific Reports · doi:10.1038/s41598-021-92890-w · Cited by 25 · see citing works
Mokros, Ł., Nowakowska-Domagała, K., Koprowicz, J., Witusik, A., & Pietras, T. (2021) · Chronobiology International · doi:10.1080/07420528.2020.1865393 · Cited by 25 · see citing works
“…as a risk factor for both clinically significant depressive symptoms and psychiatric treatment in the general adult population, as it predisposes the individual to poor sleep quality, sleep debt, and desynchronization between biological and social rhythm (Au and Reece 2017; Merikanto et al. 2015).”
BackgroundTonetti, L., & Natale, V. (2018) · Chronobiology International · doi:10.1080/07420528.2018.1525392 · Cited by 25 · see citing works
“, 2012 for a comprehensive review) that ET may be at higher risk for several negative health outcomes as psychiatric disorders (e.g., depression; Au and Reece 2017), cardiovascular diseases (e.”
BackgroundMa, Y., Zhang, B., Meng, Y., Cao, Y., Mao, Y.-H., & Qiu, C.-J. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.951717 · Cited by 24 · see citing works
Cheung, F., Ho, A., Chan, J., Li, X., Chan, N., Zhang, J.-H., Ho, C.-S., Wing, Y. K., & Li, S. (2022) · Chronobiology International · doi:10.1080/07420528.2022.2025821 · Cited by 24 · see citing works
“2014), mood disorders (Au and Reece 2017), cardiovascular problems, and Type 2 diabetes (Merikanto et al.”
BackgroundAssociations between chronotype and physical activity and well-being in adults
Polańska, S., Karykowska, A., & Pawelec, Ł. (2024) · Chronobiology International · doi:10.1080/07420528.2024.2321942 · Cited by 23 · see citing works
Li, B.-X., Liao, G., Lee, P., Huss, A., Ma, Y., Chan, J., Wing, Y. K., & Tse, L. (2023) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2022-220280 · Cited by 23 · see citing works
Dinu, M., Lotti, S., Napoletano, A., Corrao, A., Pagliai, G., Asensi, M. T., Gianfredi, V., Nucci, D., Colombini, B., & Sofi, F. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010335 · Cited by 23 · see citing works
Üzer, A., & Yücens, B. (2020) · Chronobiology International · doi:10.1080/07420528.2020.1775629 · Cited by 23 · see citing works
Who is happier among preclinical medical students: the impact of chronotype preference
Tan, M. N., Mevsim, V., Cifci, M. P., Sayan, H., Ercan, A. E., Ergin, O. F., Oksuz, U., & Ensari, S. (2020) · Chronobiology International · doi:10.1080/07420528.2020.1761373 · Cited by 23 · see citing works
Frank, E., Pong, J., Asher, Y., & Soares, C. N. (2018) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000382 · Cited by 23 · see citing works
24-h Activity Rhythms and Health in Older Adults
de Feijter, M., Lysen, T., & Luik, A. (2020) · Current Sleep Medicine Reports · doi:10.1007/s40675-020-00170-2 · Cited by 22 · see citing works
Gao, L., Li, P., Hu, C., To, T., Patxot, M., Falvey, B., Wong, P. M., Scheer, F., Lin, C., Lo, M., et al. (2019) · Sleep · doi:10.1093/sleep/zsz034 · Cited by 22 · see citing works
Chan, J., Chan, N., Li, S., Lam, S. P., Chau, S. W., Liu, Y.-P., Zhang, J.-H., & Wing, Y. K. (2021) · Journal of Clinical Sleep Medicine (JCSM) · doi:10.5664/jcsm.9648 · Cited by 21 · see citing works
Caruso, D., Meyrel, M., Krane-Gartiser, K., Bénard, V., Benizri, C., Brochard, H., Geoffroy, P., Gross, G., Maruani, J., Prunas, C., et al. (2020) · Chronobiology International · doi:10.1080/07420528.2019.1685533 · Cited by 21 · see citing works
“As shown in a recent meta-analysis (see Au and Reece 2017), eveningness is also related to more severe depressive symptoms and to increased emotional expressive suppression which in turn increase the risk of depression (Watts and Norbury 2017).”
ResultSirtoli, R., Mata, G., Rodrigues, R., Martínez-Vizcaíno, V., López-Gil, J., Guidoni, C., & Mesas, A. (2023) · Chronobiology International · doi:10.1080/07420528.2023.2256899 · Cited by 19 · see citing works
“The evening chronotype has been associated with poorer cardiovascular health (Makarem et al. 2020), depressive symptoms (Au and Reece 2017), metabolic disorders (Yu et al. 2015), and a higher frequency of asthma (Merikanto et al. 2014) and neurological and gastrointestinal disorders (Knutson and…”
BackgroundColeman, M. Y., & Cain, S. W. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.05.054 · Cited by 27 · see citing works
Naftalovich, H., Anholt, G. E., Keren, R., Ben Arush, O., & Kalanthroff, E. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.08.032 · Cited by 18 · see citing works
Comas, M., Flores, A. S., Lovato, N., Miller, C., Bartlett, D., Grunstein, R., Chapman, J., & Gordon, C. (2023) · Brain Science · doi:10.3390/brainsci13040613 · Cited by 18 · see citing works
“20) between eveningness chronotype and depressive symptoms [13].”
BackgroundMorning affect or sleep inertia? Comparing the constructs and their measurement
Carciofo, R. (2023) · Chronobiology International · doi:10.1080/07420528.2023.2187211 · Cited by 18 · see citing works
“…have found an association between eveningness and depression (e.g., Antypa et al. 2016; Merikanto et al. 2013 for a review see Au and Reece 2017), Konttinen et al. (2014) found that depression was more strongly associated (negatively) with the Morning Alertness factor of…”
BackgroundCooper, R., Biase, M. D. D., Bei, B., Allen, N., Schwartz, O., Whittle, S., & Cropley, V. (2022) · Journal of Child Psychology and Psychiatry and Allied Disciplines · doi:10.1111/jcpp.13718 · Cited by 18 · see citing works
“…at risk for a range of poor physiological, academic and mental health-related outcomes, including an increased risk of experiencing symptoms of internalizing and externalizing psychopathology (Au & Reece, 2017; Merikanto et al., 2017; Norbury, 2021; Schlarb et al., 2014; Urrila et al., 2015).”
BackgroundCircadian Rhythm and Pain: a Review of Current Research and Future Implications
Mun, C. J., Burgess, H., Sears, D. D., Parthasarathy, S., James, D. L., Altamirano, U., Sajith, S., Lakhotia, A., Fillingim, R., & Youngstedt, S. (2022) · Current Sleep Medicine Reports · doi:10.1007/s40675-022-00228-3 · Cited by 18 · see citing works
Sleep Duration and Post-Traumatic Stress Disorder Symptoms: A Twin Study.
McCall, C., Turkheimer, E., Tsang, S., Avery, A., Duncan, G., & Watson, N. (2019) · Sleep · doi:10.1093/sleep/zsz179 · Cited by 18 · see citing works
Kawai, H., Iwadate, R., Ishibashi, T., Kudo, N., Kawashima, Y., & Mitsumoto, A. (2019) · Chronobiology International · doi:10.1080/07420528.2019.1625360 · Cited by 18 · see citing works
“Individuals with an eveningness orientation are prone to depression and are unresponsive to antidepressant therapy (Au and Reece 2017; Merikanto et al. 2013; McGlashan et al. 2018).”
BackgroundBurns, A., Zellers, S., Windred, D., Daghlas, I., Sinnott-Armstrong, N. A., Rutter, M., Hublin, C., Friligkou, E., Polimanti, R., Phillips, A. J. K., et al. (2024) · medRxiv · doi:10.1101/2024.09.10.24313197 · Cited by 17
“These findings align with many prior studies linking evening chronotype with mood and psychotic disorders [1, 3, 5, 6, 8] and a smaller body of research that has identified sleep inertia as a common symptom across psychiatric disorder diagnoses that is strongly predictive of their prevalence and is…”
ResultKim, S. Y., Kim, H., Cho, S.-S., Park, M. Y., & Kang, M.-Y. (2023) · Annals of Occupational and Environmental Medicine · doi:10.35371/aoem.2023.35.e47 · Cited by 17 · see citing works
“27 According to the vulnerability-stress hypothesis of depression, the interplay between psychological vulnerability factors (e.g., negative biases, preferential processing of negative content) and environmental stressors (e.g., bereavement, financial uncertainty) contributes to depression.”
BackgroundWang, S., Wang, H., Deng, X., & Lei, X. (2023) · Chronobiology International · doi:10.1080/07420528.2023.2202246 · Cited by 19 · see citing works
“For example, having an evening chronotype increases the risk of sleep problems (Alvaro et al. 2014), mood disorders (Abreu and Braganca 2015; Adan et al. 2012; Au and Reece 2017), and metabolic disorders (Yu et al. 2015).”
BackgroundSleep and chronotype in adults with persistent tic disorders
Ricketts, E. J., Montalbano, G. E., Burgess, H. J., McMakin, D. L., Coles, M. E., Piacentini, J. C., & Colwell, C. S. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23323 · Cited by 20 · see citing works
Morning Light Therapy in Adults with Tourette’s Disorder
Ricketts, E., Burgess, H., Montalbano, G., Coles, M., McGuire, J., Thamrin, H., McMakin, D., McCracken, J., Carskadon, M., Piacentini, J., et al. (2021) · Journal of Neurology · doi:10.1007/s00415-021-10645-z · Cited by 17 · see citing works
Late chronotype is linked to greater cortical thickness in the left fusiform and entorhinal gyri
Zareba, M., Fąfrowicz, M., Marek, T., Beldzik, E., Oginska, H., & Domagalik, A. (2021) · Biological rhythm research · doi:10.1080/09291016.2021.1990501 · Cited by 17 · see citing works
Associations of evening-type and insomnia symptoms with depressive symptoms among youths.
Que, J.-Y., Chen, S.-J., Chan, N., Wu, S., Zhang, L., Chen, Y., Liu, J.-R., Chen, M., Chen, L., Li, S., et al. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.04.009 · Cited by 16 · see citing works
Impact of sleep chronotype on in‐laboratory polysomnography parameters
Colelli, D. R., Cruz, G. D. D., Kendzerska, T., Murray, B., & Boulos, M. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13922 · Cited by 16 · see citing works
Carciofo, R. (2022) · Chronobiology International · doi:10.1080/07420528.2022.2134787 · Cited by 16 · see citing works
“2014a), and more psychological distress and disorder (Au and Reece 2017; Taylor and Hasler 2018).”
Background
- Authors
- Au, J., & Reece, J.
- Affiliations
- ACAP University College (AU)
- Corresponding author
- Au, Jacky
- ORCID
- Reece, John
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 218
- Pages
- 93-104
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2608132284
- Cited by
- 297
- References
- 0
- Citations by year
- 2026: 24 · 2025: 42 · 2024: 48 · 2023: 40 · 2022: 35 · 2021: 42 · 2020: 23 · 2019: 22 · 2018: 16 · 2017: 5
- FWCI
- 2.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- chronotype, eveningness, depression, depressive symptoms, circadian rhythm, Composite Scale of Morningness, Morningness-Eveningness Questionnaire, chronobiology, mood disorders
- MeSH terms
- Adult, Affect, Circadian Rhythm, Depression, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Mood Disorders, Chronobiology Disorders
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