Objective: To determine the association of different chronotypes with depression in military Veterans with Parkinson’s disease (PD).

Background: Depression is a common non-motor symptom in Parkinson’s disease. Intrinsic or biological factors that might play a role in its development are not entirely known in this patient population.
Chronotype reflects the periodicity of biological rhythms and appears to have important implications with respect to mood. Although circadian rhythm disturbance has been associated with depressive disorders in PD, the role of different chronotypes in this regard remains unclear.

Method: 100 consecutive military Veterans with PD were assessed with respect to their chronotype using the Horne and Ostberg’s Morningness and Eveningness scale. Within each chronotype, subjective depression, motor, and intellectual impairment were measured using Zung Self Rating Depression Scale (ZDS), Hoehn and Yahr scale (H&Y), and Unified Parkinson’s Disease Rating Scale (UPDRS- Item 1) respectively.

Results: Chronotype distribution: 60% (60/100) were Morning Type (M) [Definitive (M++) = 12, Moderate (M+) =48], 39% (39/100) were Neither Type (N) and 1% (1/100) was Moderately Evening Type (E).
Depression (ZDS = or > 50): M++ [0% (0/12)] M+ [8.3% (4/48)], N [23% (9/39)], E [0% (0/1)].
Subject characteristics: M++ [Men- 100%, White- 91.6%, mean age 71.7 (54-90)]; M+[Men-98%, White 85%, mean age 72.6 (45-94)]; N- [Men-95%, White- 82%, Mean age 71.8 (49-89)]; E- [Man, White, age 76].
Mean H&Y scores: 2.3, 2.77, 2.77 and 2.5 for M++, M+, N and E types respectively. Intellectual impairment (UPDRS): M++ [None (25%), Mild (75%) mean = 0.75], M+ [None (16.6%) Mild (64.5%) Moderate (14.6%), Severe (4%) mean = 1.06], N [None (20.5%), Mild (53.8%), Moderate (18%),Severe (7.7%); mean=1.13], E [Mild (100%) = 1].

Conclusion: Military Veterans with Parkinson’s disease who had “Definitively Morning” chronotype (M++) did not endorse depression. A trend towards progressively increasing depression was seen from Moderately Morning (M+) to the Neither(N) chronotypes. This phenomenon requires further exploration.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/is-chronotype-a-biomarker-for-depression-in-military-veterans-with-parkinsons-disease/