Adolescents at clinical-high risk for psychosis: Circadian rhythm disturbances predict worsened prognosis at 1-year follow-up
Open accessAbstract
Background Individuals with psychotic disorders experience disruptions to both the sleep and circadian components of the sleep/wake cycle. Recent evidence has supported a role of sleep disturbances in emerging psychosis. However, less is known about how circadian rhythm disruptions may relate to psychosis symptoms and prognosis for adolescents with clinical high-risk (CHR) syndromes. The present study examines circadian rest/activity rhythms in CHR and healthy control (HC) youth to clarify the relationships among circadian rhythm disturbance, psychosis symptoms, psychosocial functioning, and the longitudinal course of illness.Methods Thirty-four CHR and 32 HC participants were administered a baseline evaluation, which included clinical interviews, 5days of actigraphy, and a sleep/activity diary. CHR (n=29) participants were re-administered clinical interviews at a 1-year follow-up assessment.Results Relative to HC, CHR youth exhibited more fragmented circadian rhythms and later onset of nocturnal rest. Circadian disturbances (fragmented rhythms, low daily activity) were associated with increased psychotic symptom severity among CHR participants at baseline. Circadian disruptions (lower daily activity, rhythms that were more fragmented and/or desynchronized with the light/dark cycle) also predicted severity of psychosis symptoms and psychosocial impairment at 1-year follow-up among CHR youth.Conclusions Circadian rhythm disturbances may represent a potential vulnerability marker for emergence of psychosis, and thus, rest/activity rhythm stabilization has promise to inform early-identification and prevention/intervention strategies for CHR youth. Future studies with longer study designs are necessary to further examine circadian rhythms in the prodromal period and rates of conversion to psychosis among CHR teens.
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Circadian disruptions in adolescents at high risk of psychosis and in individuals with mood disorders predict worse prognosis and symptoms in longitudinal studies.
“circadian disruptions in adolescents who are at high risk of psychosis (that is, subthreshold symptoms of psychosis, social impairment and higher suspicion–paranoia)197 and individuals with mood disorders predict worse prognosis and symptoms in longitudinal studies198,199”
From Rhythms of life: circadian disruption and brain disorders across the lifespan (2019) · cites this paper as [198]
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- Authors
- Lunsford-Avery, J. R., Gonçalves, B. D. S. B., Brietzke, E., Bressan, R. A., Gadelha, A., Auerbach, R. P., & Mittal, V. A.
- Affiliations
- Universidade Federal de São Paulo (BR)
- Harvard University (US)
- Northwestern University (US)
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 189
- Pages
- 37-42
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC5544586
- OpenAlex
- W2583157358
- Cited by
- 89
- References
- 55
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 13 · 2023: 11 · 2022: 11 · 2021: 12 · 2020: 9 · 2019: 8 · 2018: 8 · 2017: 5
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Funders
- National Institute of Mental Health (R21MH103231, R01MH094650, R33MH103231, K23MH108704)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- clinical high risk for psychosis, adolescents
- MeSH terms
- Adolescent, Child, Circadian Rhythm, Female, Humans, Longitudinal Studies, Male, Psychiatric Status Rating Scales, Psychotic Disorders, Sleep, Disease Progression, Young Adult, Actigraphy, Prodromal Symptoms
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