Journal Home > Volume 5 , Issue 3

Affective disorders are often accompanied by circadian rhythm disruption and the major symptoms of mental illness occur in a rhythmic manner. Chronotype, also known as circadian preference for rest or activity, is believed to exert a substantial influence on mental health. Here, we review the connection between chronotypes and affective disorders, and discuss the potential underlying mechanisms between these two phenomena.

Full text
About this article

Chronotypes and affective disorders: A clock for mood?

Show Author's information Qian Gao1Juan Sheng2Song Qin2Luoying Zhang1( )
Key Laboratory of Molecular Biophysics of Ministry of Education, College of Life Science and Technology and the Collaborative Innovation Center for Brain Science, Huazhong University of Science and Technology, Wuhan 430074, Hubei, China
Jingzhou Mental Health Center, Jingzhou 434000, Hubei, China


Affective disorders are often accompanied by circadian rhythm disruption and the major symptoms of mental illness occur in a rhythmic manner. Chronotype, also known as circadian preference for rest or activity, is believed to exert a substantial influence on mental health. Here, we review the connection between chronotypes and affective disorders, and discuss the potential underlying mechanisms between these two phenomena.


chronotype, affective disorder, circadian clock, clock gene
Received: 22 July 2019 Revised: 31 August 2019 Accepted: 01 September 2019 Published: 17 April 2020 Issue date: September 2019
JS Takahashi, HK Hong, CH Ko, et al. The genetics of mammalian circadian order and disorder: implications for physiology and disease. Nat Rev Genet. 2008, 9(10): 764-775.
SJ Li, LY Zhang. Circadian control of global transcription. Biomed Res Int. 2015, 2015: 187809.
T Roenneberg, T Kuehnle, M Juda, et al. Epidemiology of the human circadian clock. Sleep Med Rev. 2007, 11(6): 429-438.
A Adan, SN Archer, MP Hidalgo, et al. Circadian typology: a comprehensive review. Chronobiol Int. 2012, 29(9): 1153-1175.
T Roenneberg, M Merrow. The circadian clock and human health. Curr Biol. 2016, 26(10): R432-R443.
LY Zhang, YH Fu. The molecular genetics of human sleep. Eur J Neurosci. 2018, in press, .
T Roenneberg, T Kantermann, M Juda, et al. Light and the human circadian clock. In Circadian Clocks. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013.
JA Horne, O Ostberg. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol. 1976, 4(2): 97-110.
T Roenneberg, A Wirz-Justice, M Merrow. Life between clocks: daily temporal patterns of human chronotypes. J Biol Rhythms. 2003, 18(1): 80-90.
A Zavada, MC Gordijn, DG Beersma, et al. Comparison of the Munich chronotype questionnaire with the horne-ostberg’s morningness-eveningness score. Chronobiol Int. 2005, 22(2): 267-278.
AJ Lewy, NL Cutler, RL Sack. The endogenous melatonin profile as a marker for circadian phase position. J Biol Rhythms. 1999, 14(3): 227-236.
T Kantermann, H Sung, HJ Burgess. Comparing the morningness-eveningness questionnaire and Munich ChronoType questionnaire to the dim light melatonin onset. J Biol Rhythms. 2015, 30(5): 449-453.
A Gershon, CN Kaufmann, CA Depp, et al. Subjective versus objective evening chronotypes in bipolar disorder. J Affect Disord. 2018, 225: 342-349.
SN Archer, EE Laing, CS Möller-Levet, et al. Mistimed sleep disrupts circadian regulation of the human transcriptome. Proc Natl Acad Sci USA. 2014, 111(6): E682-E691.
N Wittenbrink, B Ananthasubramaniam, M Münch, et al. High-accuracy determination of internal circadian time from a single blood sample. J Clin Invest. 2018, 128(9): 3826-3839.
R Braun, WL Kath, M Iwanaszko, et al. Universal method for robust detection of circadian state from gene expression. Proc Natl Acad Sci USA. 2018, 115(39): E9247-E9256.
EE Laing, CS Möller-Levet, N Poh, et al. Blood transcriptome based biomarkers for human circadian phase. Elife. 2017, 6: e20214.
I Soreca. Circadian rhythms and sleep in bipolar disorder: implications for pathophysiology and treatment. Curr Opin Psychiatry. 2014, 27(6): 467-471.
JZ Li, BG Bunney, F Meng, et al. Circadian patterns of gene expression in the human brain and disruption in major depressive disorder. Proc Natl Acad Sci USA. 2013, 110(24): 9950-9955.
LM Lyall, CA Wyse, N Graham, et al. Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: a cross-sectional study of 91 105 participants from the UK Biobank. Lancet Psychiatry. 2018, 5(6): 507-514.
R Uher, JL Payne, B Pavlova, et al. Major depressive disorder in DSM-5: implications for clinical practice and research of changes from DSM-IV. Depress Anxiety. 2014, 31(6): 459-471.
MD Drennan, MR Klauber, DF Kripke, et al. The effects of depression and age on the Horne-Ostberg morningness-eveningness score. J Affect Disord. 1991, 23(2): 93-98.
N Antypa, N Vogelzangs, Y Meesters, et al. Chronotype associations with depression and anxiety disorders in a large cohort study. Depress Anxiety. 2016, 33(1): 75-83.
S Fares, DF Hermens, SL Naismith, et al. Clinical correlates of chronotypes in young persons with mental disorders. Chronobiol Int. 2015, 32(9): 1183-1191.
MJ Müller, B Kundermann, N Cabanel. Eveningness and poor sleep quality independently contribute to self-reported depression severity in psychiatric inpatients with affective disorder. Nord J Psychiatry. 2016, 70(5): 329-334.
MJ Müller, N Cabanel, C Olschinski, et al. Chronotypes in patients with nonseasonal depressive disorder: Distribution, stability and association with clinical variables. Chronobiol Int. 2015, 32(10): 1343-1351.
MY Coleman, SW Cain. Eveningness is associated with greater subjective cognitive impairment in individuals with self-reported symptoms of unipolar depression. J Affect Disord. 2019, 256: 404-415.
MJ Müller, C Olschinski, B Kundermann, et al. Patterns of self-reported depressive symptoms in relation to morningness-eveningness in inpatients with a depressive disorder. Psychiatry Res. 2016, 239: 163-168.
YC Bahk, E Han, SH Lee. Biological rhythm differences and suicidal ideation in patients with major depressive disorder. J Affect Disord. 2014, 168: 294-297.
JW Chan, SP Lam, SX Li, et al. Eveningness and insomnia: independent risk factors of nonremission in major depressive disorder. Sleep. 2014, 37(5): 911-917.
I Merikanto, E Kronholm, M Peltonen, et al. Circadian preference links to depression in general adult population. J Affect Disord. 2015, 188: 143-148.
JM Lane, I Vlasac, SG Anderson, et al. Genome- wide association analysis identifies novel loci for chronotype in 100, 420 individuals from the UK Biobank. Nat Commun. 2016, 7: 10889.
I Merikanto, T Lahti, E Kronholm, et al. Evening types are prone to depression. Chronobiol Int. 2013, 30(5): 719-725.
G Prat, . Relationships among circadian typology, psychological symptoms, and sensation seeking. Chronobiol Int. 2013, 30(7): 942-949.
WH Chiu, HJ Yang, PH Kuo. Chronotype preference matters for depression in youth. Chronobiol Int. 2017, 34(7): 933-941.
S Kitamura, A Hida, M Watanabe, et al. Evening preference is related to the incidence of depressive states independent of sleep-wake conditions. Chronobiol Int. 2010, 27(9/10): 1797-1812.
PK Alvaro, RM Roberts, JK Harris. The independent relationships between insomnia, depression, subtypes of anxiety, and chronotype during adolescence. Sleep Med. 2014, 15(8): 934-941.
C Nguyen, G Murray, S Anderson, et al. In vivo molecular chronotyping, circadian misalignment, and high rates of depression in young adults. J Affect Disord. 2019, 250: 425-431.
F Romo-Nava, SA Tafoya, J Gutiérrez-Soriano, et al. The association between chronotype and perceived academic stress to depression in medical students. Chronobiol Int. 2016, 33(10): 1359-1368.
SR Pabst, S Negriff, LD Dorn, et al. Depression and anxiety in adolescent females: the impact of sleep preference and body mass index. J Adolesc Health. 2009, 44(6): 554-560.
DA Haraden, BC Mullin, BL Hankin. Internalizing symptoms and chronotype in youth: a longitudinal assessment of anxiety, depression and tripartite model. Psychiatry Res. 2019, 272: 797-805.
T Abe, Y Inoue, Y Komada, et al. Relation between morningness-eveningness score and depressive symptoms among patients with delayed sleep phase syndrome. Sleep Med. 2011, 12(7): 680-684.
KJ Reid, AA Jaksa, JB Eisengart, et al. Systematic evaluation of Axis-I DSM diagnoses in delayed sleep phase disorder and evening-type circadian preference. Sleep Med. 2012, 13(9): 1171-1177.
DF Kripke, JA Elliott, DK Welsh, et al. Photoperiodic and circadian bifurcation theories of depression and Mania. F1000Res. 2015, 4: 107.
H Einat, N Kronfeld-Schor, D Eilam. Sand rats see the light: short photoperiod induces a depression-like response in a diurnal rodent. Behav Brain Res. 2006, 173(1): 153-157.
NE Rosenthal, DA Sack, JC Gillin, et al. Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry. 1984, 41(1): 72-80.
Y Meesters, MC Gordijn. Seasonal affective disorder, winter type: current insights and treatment options. Psychol Res Behav Manag. 2016, 9: 317-327.
N Sandman, I Merikanto, H Määttänen, et al. Winter is coming: nightmares and sleep problems during seasonal affective disorder. J Sleep Res. 2016, 25(5): 612-619.
MF Borisenkov, NB Petrova, VD Timonin, et al. Sleep characteristics, chronotype and winter depression in 10-20-year-olds in northern European Russia. J Sleep Res. 2015, 24(3): 288-295.
HJ Lee, KM Rex, CM Nievergelt, et al. Delayed sleep phase syndrome is related to seasonal affective disorder. J Affect Disord. 2011, 133(3): 573-579.
N Chen, Q Wu, YL Xiong, et al. Circadian rhythm and sleep during prolonged Antarctic residence at Chinese Zhongshan station. Wilderness Environ Med. 2016, 27(4): 458-467.
B Bowers, R Flory, J Ametepe, et al. Controlled trial evaluation of exposure duration to negative air ions for the treatment of seasonal affective disorder. Psychiatry Res. 2018, 259: 7-14.
H Oginska, K Oginska-Bruchal. Chronotype and personality factors of predisposition to seasonal affective disorder. Chronobiol Int. 2014, 31(4): 523-531.
SE Knapen, MC Gordijn, Y Meesters. The relation between chronotype and treatment outcome with light therapy on a fixed time schedule. J Affect Disord. 2016, 202: 87-90.
L Tonetti, M Fabbri, M Martoni, et al. Circadian type and mood seasonality in adolescents. Psychiatry Clin Neurosci. 2012, 66(2): 157-159.
V Natale, , P Scapellato. Are seasonality of mood and eveningness closely associated? Psychiatry Res. 2005, 136(1): 51-60.
G Murray, NB Allen, J Trinder. Seasonality and circadian phase delay: prospective evidence that winter lowering of mood is associated with a shift towards Eveningness. J Affect Disord. 2003, 76(1/2/3): 15-22.
I Merikanto, J Suvisaari, T Lahti, et al. Eveningness relates to burnout and seasonal sleep and mood problems among young adults. Nord J Psychiatry. 2016, 70(1): 72-80.
LY Zhang, DS Evans, UK Raheja, et al. Chronotype and seasonality: morningness is associated with lower seasonal mood and behavior changes in the Old Order Amish. J Affect Disord. 2015, 174: 209-214.
NM Oyane, I Bjelland, S Pallesen, et al. Seasonality is associated with anxiety and depression: the Hordaland health study. J Affect Disord. 2008, 105(1/2/3): 147-155.
JH Baek, JS Kim, MJ Kim, et al. Lifetime characteristics of evening-preference and irregular bed-rise time are associated with lifetime seasonal variation of mood and behavior: comparison between individuals with bipolar disorder and healthy controls. Behav Sleep Med. 2016, 14(2): 155-168.
L Tondo, GH Vázquez, RJ Baldessarini. Depression and Mania in bipolar disorder. Curr Neuropharmacol. 2017, 15(3): 353-358.
MCA Melo, RLC Abreu, VB Linhares Neto, et al. Chronotype and circadian rhythm in bipolar disorder: a systematic review. Sleep Med Rev. 2017, 34: 46-58.
CN Kaufmann, A Gershon, CA Depp, et al. Daytime midpoint as a digital biomarker for chronotype in bipolar disorder. J Affect Disord. 2018, 241: 586-591.
KL Kim, AB Weissman, ME Puzia, et al. Circadian phase preference in pediatric bipolar disorder. J Clin Med. 2014, 3(1): 255-266.
H Jeong Jeong, E Moon, J Min Park, et al. The relationship between chronotype and mood fluctuation in the general population. Psychiatry Res. 2015, 229(3): 867-871.
AA Chrobak, A Tereszko, D Dembinska-Krajewska, et al. The role of affective temperaments assessed by the Temperament Evaluation of Memphis, Pisa and San Diego-Autoquestionnaire (TEMPS-A) in the relationship between morningness-eveningness and bipolarity. J Affect Disord. 2018, 232: 83-88.
O Godin, C Henry, M Leboyer, et al. Sleep quality, chronotype and metabolic syndrome components in bipolar disorders during the remission period: Results from the FACE-BD cohort. Chronobiol Int. 2017, 34(8): 1114-1124.
LM Giglio, PV Magalhães, ML Andersen, et al. Circadian preference in bipolar disorder. Schlaf Atmung. 2010, 14(2): 153-155.
C Boudebesse, M Lajnef, PA Geoffroy, et al. Chronotypes of bipolar patients in remission: validation of the French version of the circadian type inventory in the FACE-BD sample. Chronobiol Int. 2013, 30(8): 1042-1049.
EF Saunders, DM Novick, J Fernandez-Mendoza, et al. Sleep quality during Euthymia in bipolar disorder: the role of clinical features, personality traits, and stressful life events. Int J Bipolar Disord. 2013, 1: 16.
K Subramanian, S Sarkar, S Kattimani. Bipolar disorder in Asia: Illness course and contributing factors. Asian J Psychiatr. 2017, 29: 16-29.
S Pirkola, HA Eriksen, T Partonen, et al. Seasonal variation in affective and other clinical symptoms among high-risk families for bipolar disorders in an Arctic population. Int J Circumpolar Health. 2015, 74: 29671.
J Wood, B Birmaher, D Axelson, et al. Replicable differences in preferred circadian phase between bipolar disorder patients and control individuals. Psychiatry Res. 2009, 166(2/3): 201-209.
SB Ashman, TH Monk, DJ Kupfer, et al. Relationship between social rhythms and mood in patients with rapid cycling bipolar disorder. Psychiatry Res. 1999, 86(1): 1-8.
MJ McCarthy, H Wei, CM Nievergelt, et al. Chronotype and cellular circadian rhythms predict the clinical response to Lithium maintenance treatment in patients with bipolar disorder. Neuropsychopharmacology. 2019, 44(3): 620-628.
K Kanagarajan, K Gou, C Antinora, et al. Morningness- Eveningness questionnaire in bipolar disorder. Psychiatry Res. 2018, 262: 102-107.
MA Seleem, JA Merranko, TR Goldstein, et al. The longitudinal course of sleep timing and circadian preferences in adults with bipolar disorder. Bipolar Disord. 2015, 17(4): 392-402.
YM Ahn, J Chang, YH Joo, et al. Chronotype distribution in bipolar I disorder and schizophrenia in a Korean sample. Bipolar Disord. 2008, 10(2): 271-275.
HA Mansour, J Wood, KV Chowdari, et al. Circadian phase variation in bipolar I disorder. Chronobiol Int. 2005, 22(3): 571-584.
JK Chung, KY Lee, SH Kim, et al. Circadian rhythm characteristics in mood disorders: comparison among bipolar I disorder, bipolar II disorder and recurrent major depressive disorder. Clin Psychopharmacol Neurosci. 2012, 10(2): 110-116.
MG Craske, MB Stein. Anxiety. Lancet. 2017, 388(10063): 3048-3059.
P Lemoine, P Zawieja, MM Ohayon. Associations between morningness/eveningness and psychopathology: an epidemiological survey in three in-patient psychiatric clinics. J Psychiatr Res. 2013, 47(8): 1095-1098.
RC Cox, BO Olatunji. Differential associations between chronotype, anxiety, and negative affect: a structural equation modeling approach. J Affect Disord. 2019, 257: 321-330.
PJ López-Soto, F Fabbian, R Cappadona, et al. Chronotype, nursing activity, and gender: a systematic review. J Adv Nurs. 2019, 75(4): 734-748.
CI Park, SK An, HW Kim, et al. Relationships between chronotypes and affective temperaments in healthy young adults. J Affect Disord. 2015, 175: 256-259.
YH Lin, SS Gau. Association between morningness- eveningness and the severity of compulsive Internet use: the moderating role of gender and parenting style. Sleep Med. 2013, 14(12): 1398-1404.
CY Hsu, SS Gau, CY Shang, et al. Associations between chronotypes, psychopathology, and personality among incoming college students. Chronobiol Int. 2012, 29(4): 491-501.
E Vardar, SA Vardar, T Molla, et al. Psychological symptoms and sleep quality in young subjects with different circadian preferences. Biol Rhythm Res. 2008, 39(6): 493-500.
M Nagane, , S Watanabe. Relationship between psychosomatic complaints and circadian rhythm irregularity assessed by salivary levels of melatonin and growth hormone. J Circadian Rhythms. 2011, 9: 9.
JF Díaz-Morales. Anxiety during adolescence: considering morningness-eveningness as a risk factor. Sleep Biol Rhythms. 2016, 14(2): 141-147.
DJ Taylor, KC Clay, AD Bramoweth, et al. Circadian phase preference in college students: relationships with psychological functioning and academics. Chronobiol Int. 2011, 28(6): 541-547.
MJ Zylka, LP Shearman, DR Weaver, et al. Three period homologs in mammals: differential light responses in the suprachiasmatic circadian clock and oscillating transcripts outside of brain. Neuron. 1998, 20(6): 1103-1110.
K Yagita, S Yamaguchi, F Tamanini, et al. Dimerization and nuclear entry of mPER proteins in mammalian cells. Genes Dev. 2000, 14(11): 1353-1363.
LP Shearman, X Jin, C Lee, et al. Targeted disruption of the mPer3 gene: subtle effects on circadian clock function. Mol Cell Biol. 2000, 20(17): 6269-6275.
S Hasan, DR van der Veen, R Winsky-Sommerer, et al. Altered sleep and behavioral activity phenotypes in PER3-deficient mice. Am J Physiol-Regul Integr Comp Physiol. 2011, 301(6): R1821-R1830.
SN Archer, C Schmidt, G Vandewalle, et al. Phenotyping of PER3 variants reveals widespread effects on circadian preference, sleep regulation, and health. Sleep Med Rev. 2018, 40: 109-126.
LY Zhang, A Hirano, PK Hsu, et al. A PERIOD3 variant causes a circadian phenotype and is associated with a seasonal mood trait. Proc Natl Acad Sci USA. 2016, 113(11): E1536-E1544.
T Ebisawa, M Uchiyama, N Kajimura, et al. Association of structural polymorphisms in the human period3 gene with delayed sleep phase syndrome. EMBO Rep. 2001, 2(4): 342-346.
SN Archer, DL Robilliard, DJ Skene, et al. A length polymorphism in the circadian clock gene Per3 is linked to delayed sleep phase syndrome and extreme diurnal preference. Sleep. 2003, 26(4): 413-415.
DS Pereira, S Tufik, FM Louzada, et al. Association of the length polymorphism in the human Per3 gene with the delayed sleep-phase syndrome: does latitude have an influence upon it? Sleep. 2005, 28(1): 29-32.
AS Lázár, A Slak, JC Lo, et al. Sleep, diurnal preference, health, and psychological well-being: a prospective single-allelic-variation study. Chronobiol Int. 2012, 29(2): 131-146.
L Kunorozva, KJ Stephenson, DE Rae, et al. Chronotype and PERIOD3 variable number tandem repeat polymorphism in individual sports Athletes. Chronobiol Int. 2012, 29(8): 1004-1010.
KH Jones, J Ellis, M von Schantz, et al. Age-related change in the association between a polymorphism in the PER3 gene and preferred timing of sleep and waking activities. J Sleep Res. 2007, 16(1): 12-16.
AR Liberman, SB Kwon, HT Vu, et al. Circadian clock model supports molecular link between PER3 and human anxiety. Sci Rep. 2017, 7(1): 9893.
AR Liberman, L Halitjaha, A Ay, et al. Modeling strengthens molecular link between circadian polymorphisms and major mood disorders. J Biol Rhythms. 2018, 33(3): 318-336.
F Benedetti, S Dallaspezia, C Colombo, et al. A length polymorphism in the circadian clock gene Per3 influences age at onset of bipolar disorder. Neurosci Lett. 2008, 445(2): 184-187.
M Doi, J Hirayama, P Sassone-Corsi. Circadian regulator CLOCK is a histone acetyltransferase. Cell. 2006, 125(3): 497-508.
DP King, Y Zhao, AM Sangoram, et al. Positional cloning of the mouse circadian clock gene. Cell. 1997, 89(4): 641-653.
AR Ozburn, K Purohit, PK Parekh, et al. Functional implications of the CLOCK 3111T/C single- nucleotide polymorphism. Front Psychiatry. 2016, 7: 67.
SQ Shi, MJ White, HM Borsetti, et al. Molecular analyses of circadian gene variants reveal sex- dependent links between depression and clocks. Transl Psychiatry. 2016, 6: e748.
D Katzenberg, T Young, L Finn, et al. A CLOCK polymorphism associated with human diurnal preference. Sleep. 1998, 21(6): 569-576.
K Mishima, T Tozawa, K Satoh, et al. The 3111T/C polymorphism of hClock is associated with evening preference and delayed sleep timing in a Japanese population sample. Am J Med Genet B Neuropsychiatr Genet. 2005, 133B(1): 101-104.
DL Robilliard, SN Archer, J Arendt, et al. The 3111 Clock gene polymorphism is not associated with sleep and circadian rhythmicity in phenotypically characterized human subjects. J Sleep Res. 2002, 11(4): 305-312.
M Pedrazzoli, FM Louzada, DS Pereira, et al. Clock polymorphisms and circadian rhythms phenotypes in a sample of the Brazilian population. Chronobiol Int. 2007, 24(1): 1-8.
N Antypa, L Mandelli, FA Nearchou, et al. The 3111T/C polymorphism interacts with stressful life events to influence patterns of sleep in females. Chronobiol Int. 2012, 29(7): 891-897.
R Calati, E Gaspar-Barba, A Yukler, et al. T3111C clock single nucleotide polymorphism and mood disorders: a meta-analysis. Chronobiol Int. 2010, 27(4): 706-721.
T Kishi, R Yoshimura, Y Fukuo, et al. The CLOCK gene and mood disorders: a case-control study and meta-analysis. Chronobiol Int. 2011, 28(9): 825-833.
F Benedetti, S Dallaspezia, MC Fulgosi, et al. Actimetric evidence that CLOCK 3111 T/C SNP influences sleep and activity patterns in patients affected by bipolar depression. Am J Med Genet B Neuropsychiatr Genet. 2007, 144B(5): 631-635.
F Benedetti, A Serretti, C Colombo, et al. Influence of CLOCK gene polymorphism on circadian mood fluctuation and illness recurrence in bipolar depression. Am J Med Genet B Neuropsychiatr Genet. 2003, 123B(1): 23-26.
F Benedetti, R Riccaboni, S Dallaspezia, et al. Effects of CLOCK gene variants and early stress on hopelessness and suicide in bipolar depression. Chronobiol Int. 2015, 32(8): 1156-1161.
K Roybal, D Theobold, A Graham, et al. Mania-like behavior induced by disruption of CLOCK. Proc Natl Acad Sci U S A. 2007, 104(15): 6406-6411.
L Coque, S Mukherjee, JL Cao, et al. Specific role of VTA dopamine neuronal firing rates and morphology in the reversal of anxiety-related, but not depression-related behavior in the ClockΔ19 mouse model of Mania. Neuropsychopharmacology. 2011, 36(7): 1478-1488.
MM Sidor, SM Spencer, K Dzirasa, et al. Daytime spikes in dopaminergic activity drive rapid mood- cycling in mice. Mol Psychiatry. 2015, 20(11): 1479-1480.
M Wittmann, J Dinich, M Merrow, et al. Social jetlag: misalignment of biological and social time. Chronobiol Int. 2006, 23(1/2): 497-509.
SE Knapen, RF Riemersma-van der Lek, N Antypa, et al. Social jetlag and depression status: Results obtained from the Netherlands Study of Depression and Anxiety. Chronobiol Int. 2018, 35(1): 1-7.
B Sheaves, K Porcheret, A Tsanas, et al. Insomnia, nightmares, and chronotype as markers of risk for severe mental illness: results from a student population. Sleep. 2016, 39(1): 173-181.
P Simor, Z Zavecz, V Pálosi, et al. The influence of sleep complaints on the association between chronotype and negative emotionality in young adults. Chronobiol Int. 2015, 32(1): 1-10.
GA Kerkhof, HP van Dongen. Morning-type and evening-type individuals differ in the phase position of their endogenous circadian oscillator. Neurosci Lett. 1996, 218(3): 153-156.
X Liu, M Uchiyama, K Shibui, et al. Diurnal preference, sleep habits, circadian sleep propensity and melatonin rhythm in healthy human subjects. Neurosci Lett. 2000, 280(3): 199-202.
JF Duffy, DJ Dijk, EF Hall, et al. Relationship of endogenous circadian melatonin and temperature rhythms to self-reported preference for morning or evening activity in young and older people. J Investig Med. 1999, 47(3): 141-150.
TL Sletten, S Vincenzi, JR Redman, et al. Timing of sleep and its relationship with the endogenous melatonin rhythm. Front Neurol. 2010, 1: 137.
G Pail, W Huf, E Pjrek, et al. Bright-light therapy in the treatment of mood disorders. Neuropsychobiology. 2011, 64(3): 152-162.
D Sikkens, RF Riemersma-van der Lek, Y Meesters, et al. Combined sleep deprivation and light therapy: Clinical treatment outcomes in patients with complex unipolar and bipolar depression. J Affect Disord. 2019, 246: 727-730.
N Antypa, B Verkuil, M Molendijk, et al. Associations between chronotypes and psychological vulnerability factors of depression. Chronobiol Int. 2017, 34(8): 1125-1135.
AL Watts, R Norbury. Reduced effective emotion regulation in night owls. J Biol Rhythms. 2017, 32(4): 369-375.
Publication history
Rights and permissions

Publication history

Received: 22 July 2019
Revised: 31 August 2019
Accepted: 01 September 2019
Published: 17 April 2020
Issue date: September 2019


© The authors 2019


This work was supported by grants from the Natural Science Foundation of China (No. 31930021, No. 31671360) to Luoying Zhang, and China Postdoctoral Science Foundation (No. 2018M632826) to Qiang Gao.

Rights and permissions

Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (