Waxing and waning: The roles of chronotype and time of day in predicting symptom fluctuations in obsessive-compulsive disorder using a daily-monitoring design

Hadar Naftalovich, Gideon E. Anholt, Rotem Keren, Oded Ben Arush, Eyal Kalanthroff

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Obsessive-compulsive disorder (OCD) symptoms fluctuate throughout the day, but scientists are not sure what underlies these fluctuations. One factor which may explain how OCD symptoms wax and wane throughout the day is alertness. Increased alertness is associated with greater inhibitory control, a factor which plays a significant role in patients’ ability to overcome their OCD symptoms. The current study examined the relationship between chronotype (morningness/eveningness preference, a measure of alertness) and within-day OCD symptom severity fluctuations. We hypothesized that increased alertness leads to better inhibitory abilities and, therefore, reduced OCD symptoms. OCD Symptoms were measured through 7-days of monitoring in which participants were asked to retrospectively rate their symptoms at several timepoints throughout the day. Chronotype was measured using the Morningness/Eveningness Questionnaire (MEQ). Consistent with our hypotheses, results revealed an interaction between chronotype and time of day, such that those with an eveningness preference tended to have worse symptoms in the morning, and vice versa. In addition, we also report novel findings regarding the effect of bedtime, sleep duration, and sleep quality on symptom severity the next day. Taken together, these findings suggest that alertness may modulate OCD symptom severity throughout the day such that individuals experience more severe symptoms during times of low alertness. The clinical and theoretical implications of these findings are discussed.

Original languageEnglish
Pages (from-to)91-97
Number of pages7
JournalJournal of Psychiatric Research
Volume143
DOIs
StatePublished - 1 Nov 2021

Keywords

  • Alertness
  • Chronotype
  • Circadian rhythm
  • Inhibition
  • Obsessive-compulsive disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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