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Übersichtsarbeit

Chronotyp und Depression bei Jugendlichen – ein Review

Published Online:March 17, 2016https://doi.org/10.1024/1422-4917/a000406

Abstract

Zusammenfassung. Depressive Erkrankungen gehen mit vielen Symptomen einher, die in Bezug zu einer tageszeitlichen Rhythmik und dem Schlafverhalten stehen. Die vielfältigen Zusammenhänge zwischen Schlaf, Depression und Tagesrhythmik sind nicht eindeutig geklärt. In den Forschungsarbeiten der letzten Jahre kommt dem Chronotyp eine besondere Bedeutung zu. Als biologisches Maß der inneren Uhr kann der Chronotyp – basierend auf Schlafzeiten – mit dem Munich ChronoType Questionnaire (MCTQ) bestimmt werden, als subjektive Präferenz für bestimmte Tageszeiten wird er mit dem Morningness-Eveningness-Questionnaire (MEQ) erfasst. Durch eine systematische Literaturrecherche konnten Studien identifiziert werden, die überwiegend einen Zusammenhang zwischen einem späten Chronotyp und depressiven Symptomen und depressiven Störungen zeigen. Dies ist besonders für Jugendliche relevant, da sich der Chronotyp zur Adoleszenz hin stark verändert. Bisher ist nicht geklärt, was am Zusammenhang zwischen Chronotyp und depressiver Störung Ursache und Wirkung ist und welche Faktoren als Moderator oder Mediator fungieren. Möglicherweise ist der Zusammenhang bidirektional: Einerseits ziehen sich Patienten mit depressiven Störungen häufig zurück und sind weniger Tageslicht ausgesetzt, was ihren Chronotyp später werden lässt. Andererseits führt eine Diskrepanz von Innenzeit (festgelegt durch die innere Uhr) und Außenzeit (z. B. durch Schul- und Arbeitszeiten) zu Problemen wie einer verringerten Schlafqualität und schlechteren Schulnoten, die wiederum im Zusammenhang mit Depressivität stehen können.


Chronotype and depression in adolescents – a review

Abstract. Many patients with depressive disorders experience symptoms in relation to sleep behavior and daily rhythmicity. However, the multifaceted associations between sleep, depression and circadian rhythms are not fully understood. During the past years, the concept of chronotype has become increasingly popular in research. The Munich Chronotype Questionnaire (MCTQ) derives chronotype from sleep timing on work-free days and therefore represents a biological measure for the circadian clock, whereas the Morningness-Eveningness-Questionnaire (MEQ) assesses chronotype as a subjective preference for different activities at specific times of day. Chronotype changes with age, with adolescents and young adults being especially late types. We conducted a systematic literature research and identified studies that explore the association between chronotype (MEQ, MCTQ) and depressive symptoms or depressive disorders. Most of the studies showed an association between a late chronotype and depressive symptomatology. However, it is still unclear what is cause and effect. We propose a bidirectional relationship: On the one hand, due to reduced social and physical activity, depressed patients get less daylight which causes their chronotype to delay. On the other hand, a discrepancy between internal time (directed by the circadian clock) and external time (such as early school- or work starting times) can cause problems like reduced quality of sleep quality, daytime tiredness and worse grades in school, that are in turn associated with depressive symptoms.

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