Sleep, circadian rhythm, and physical activity patterns in depressive and anxiety disorders: A 2‐week ambulatory assessment study

Abstract

Background Actigraphy may provide a more valid assessment of sleep, circadian rhythm (CR), and physical activity (PA) than self‐reported questionnaires, but has not been used widely to study the association with depression/anxiety and their clinical characteristics. Methods Fourteen‐day actigraphy data of 359 participants with current (n = 93), remitted (n = 176), or no (n = 90) composite international diagnostic interview depression/anxiety diagnoses were obtained from the Netherlands Study of Depression and Anxiety. Objective estimates included sleep duration (SD), sleep efficiency, relative amplitude (RA) between day‐time and night‐time activity, mid sleep on free days (MSF), gross motor activity (GMA), and moderate‐to‐vigorous PA (MVPA). Self‐reported measures included insomnia rating scale, SD, MSF, metabolic equivalent total, and MVPA. Results Compared to controls, individuals with current depression/anxiety had a significantly different objective, but not self‐reported, PA and CR: lower GMA (23.83 vs. 27.4 milli‐gravity/day, p = .022), lower MVPA (35.32 vs. 47.64 min/day, p = .023), lower RA (0.82 vs. 0.83, p = .033). In contrast, self‐reported, but not objective, sleep differed between people with current depression/anxiety compared to those without current disorders; people with current depression/anxiety reported both shorter and longer SD and more insomnia. More depressive/anxiety symptoms and number of depressive/anxiety diagnoses were associated with larger disturbances of the actigraphy measures. Conclusion Actigraphy provides ecologically valid information on sleep, CR, and PA that enhances data from self‐reported questionnaires. As those with more severe or comorbid forms showed the lowest PA and most CR disruptions, the potential for adjunctive behavioral and chronotherapy interventions should be explored, as well as the potential of actigraphy to monitor treatment response to such interventions.

Affect fluctuations examined with ecological momentary assessment in patients with current or remitted depression and anxiety disorders

“…The interviews were conducted by trained clinical research staff. The 384 participants included in this study were divided into three groups based on their CIDI diagnosis, analogous to Difrancesco et al (2019): (1) a current group with a depressive and/or anxiety disorder in the past 6 months at the 9-year follow-up interview (n = 100), (2) a remitted group with a lifetime depressive disorder and/or anxiety disorder but not in the 6 months prior to the 9-year follow-up interview (n = 190), and (3) a control group with no lifetime history of depressive and/or anxiety disorders (n = 94).…”

“…Severity of depressive and anxiety symptoms were assessed with the 30-item Inventory of Depressive Symptomatology (IDS; Rush, Gullion, Basco, Jarrett, and Trivedi, 1996) and the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, and Steer, 1988). Analogous to Difrancesco et al (2019), the number of comorbid psychiatric disorders was the sum of current depressive and anxiety diagnoses at 9-year follow-up. Frequency of depressive or anxiety disorders was calculated as a count of the number of waves at which patients reported a depression and/or anxiety diagnosis during the in-between follow-up periods (ranging from 1-5 waves).…”

24-h Activity Rhythms and Health in Older Adults

“…For anxiety, relatively common at older age, it was shown that more fragmented 24-h activity rhythms were associated with higher odds of having an anxiety disorder [52], and that lower activity levels and a lower mesor were associated with current anxiety [48]. Additionally, disrupted 24-h activity rhythms have also been linked to more suicidal behaviors [63,64], but the causality of this association remains to be determined.…”

Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders

“…The aim of this study was to explore perceived burden and adherence to smartphone-based EMA questionnaires in persons with affective disorders sampled from the Ecological Momentary Assessment (EMA) and Actigraphy sub-study (NESDA-EMAA) [19,20]. As well as persons with affective disorders, the cohort also included remitted persons and healthy controls.…”