Chronotype and subthreshold bipolar disorder: emotional dysregulation and affective temperaments in the Italian general population
G. Pontoni, S. Caiolo, A. Miola, A. Sarzetto, F. SambataroIntroduction
Growing evidence supports an association between chronotype and mental health. In particular, the evening chronotype (ET) has been associated with increased vulnerability to bipolar disorder (BD).
Objectives
This study aimed to estimate the prevalence of the different chronotypes in the general population, confirm the association between ET and subthreshold BD, clarify whether chronotype is associated with BD-related psychopathological dimensions and identify factors associated with subthreshold BD in the general population.
Methods
A self-administered questionnaire including the reduced Morningness Eveningness Questionnaire (rMEQ), Brief-TEMPS-M, Difficulties in Emotion Regulation Scale (DERS), MDQ Mood disorder Questionnaire (MDQ) and Hypomania Check List-32, second revision (HCL-32-R2) scales was distributed to individuals attending of different Covid-19 vaccination centers and Covid-19 points of care.
Results
A total of 2031 participants from the general population were enrolled. Overall, 22.8% of subjects had an evening chronotype (ET), 22.2% had a morning type (MT), and 55.0% displayed neither chronotype (NT). Significantly higher scores for depressive, anxious, irritable and cyclothymic affective temperament, along with a significant emotional dysregulation, were found in subjects with ET chronotype compared with MT and NT groups. The rMEQ score was significantly correlated with both the Brief-Temps M and the DERS scores. ET chronotypes exhibited significantly higher scores on both the MDQ and HCL-32-R2 scales, and a significant correlation was found between such scales and the rMEQ. ET chronotype and tobacco consumption were the only two factors, among those in Image 1, predicting subthreshold BD on both MDQ (Geneva and Hirschfeld scores) and HCL-32-R2 scales through a multivariate logistic regression model. In the same model, a good or excellent sleep quality was found to be a significant protector from subthreshold BP on both MDQ and HCL-32-R2 scales.
Image 1: Long description.