Author's personal copy Research Report Depressive symptomatology is influenced by chronotypes Enrique Gaspar-Barba a , Raffaella Calati b , Carlos S. Cruz-Fuentes a , Martha P. Ontiveros-Uribe a , Vincenzo Natale c , Diana De Ronchi b , Alessandro Serretti b, ⁎ a National Institute of Psychiatry, Mexico b Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy c Department of Psychology, University of Bologna, Bologna, Italy article info abstract Article history: Received 3 October 2008 Received in revised form 25 February 2009 Accepted 26 February 2009 Available online 13 March 2009 Background: Rhythm disturbances are a frequent clinical manifestation of depression. In recent years a possible relationship between depression and chronotypes has emerged. Specifically eveningness has been proposed as vulnerability factor. The aim of this study was to describe sleep features of depressed patients according to chronotypes and to explore possible associations with the clinical features of depressive episodes. Methods: 100 patients diagnosed with Major Depressive Disorder according to the Mini International Neuropsychiatric Interview (MINI) were included (age: 34±11.74, range: 18– 60 years; female/male:79/21). At admission the Hamilton Rating Scale for Depression (HRSD) was administered. Patients were also administered the Morningness–Eveningness Questionnaire (MEQ), the Epworth Sleepiness Scale, the Athens Insomnia Scale and the Pittsburgh Sleep Quality Index. Results: According to MEQ scores patients were classified in three groups: a) eveningness (n =18), b) neither (n =61) and c) morningness type (n =21). The age was different among chronotypes, being morningness-type patients older. The eveningness-type group showed higher scores in suicidal thoughts, more impaired work and activities, higher paranoid symptoms, higher scores on the anxiety cluster (HRSD), while the morningness-type group showed lower proportion of melancholic symptoms (MINI). We did not find association between sleep parameters and specific chronotypes. Limitations: The relatively small sample size and the concurrent assessment of chronotypes and depression may have biased our findings. Conclusions: Our data suggest the idea that chronotypes have an impact on depressive episodes features, with higher severity for the eveningness-type. © 2009 Elsevier B.V. All rights reserved. Keywords: Depression Circadian rhythms Eveningness–morningness 1. Introduction Circadian alterations (e.g., mood fluctuations, sleep distur- bances) are a frequent clinical manifestation of depression (Germain and Kupfer, 2008) as well as features reported in healthy volunteers in terms of diurnal variation in subjective measures of mood (Monk et al.,1992; Wirz-Justice, 2008; Wood and Magnello, 1992). Regarding depression, the classic symptom of the melan- cholic subtype of major depression is even represented by diurnal mood variation (American Psychiatric Association, 2002). In particular, the early morning worsening has been always considered as a melancholic features, though recent preliminary findings suggested that diurnal mood variation as a melancholic symptom might be expanded to include any diurnal mood variation, not simply early morning worsening (Morris et al., 2007; Murray, 2008). Journal of Affective Disorders 119 (2009) 100–106 ⁎ Corresponding author. Institute of Psychiatry, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy. Tel.: +39 0516584233; fax: +39 051 521030. E-mail address: alessandro.serretti@unibo.it (A. Serretti). 0165-0327/$ – see front matter © 2009 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2009.02.021 Contents lists available at ScienceDirect Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad