The effect of chronotypes on follow-up outcomes of pati̇ents wi̇th substance use di̇sorders

INTRODUCTION: Substance use disorder (SUD) is a chronic disease with relapse and remission periods in which biological, psychological, behavioral and social factors play a role. SUD has been shown to have circadian characteristics and those who have evening chronotypes are more prone to addiction. In this study, the effect of chronotypes on the treatment outcomes of SUD was investigated. MATERIALS AND METHODS: The study included 66 patients aged 18-65 years who were admitted to Alcohol and Drug Addicts outpatient clinic between June and September 2018 and diagnosed as SUD according to DSM V diagnostic criteria. In the first interview, sociodemographic data form, addiction profile index applicator form, Beck Depression Inventory, Beck Anxiety Inventory, Morningness-Eveningness Questionnaire (MEQ) and Pittsburgh Sleep Quality Index (PSQI) were applied. Six months later, the second interview was conducted and remission / relapse status was evaluated. RESULTS: The rate of morningness was lower in SUD patients than expected morningness, eveningness and intermediate type chronotype distribution in the general adult population (20%, 20%, 60% versus 4.5%, 16.7%, 78.8%). MEQ scores of relapsed patients were found to be different in terms of eveningness than those in remission (45.62 ± 8.70 versus 49.75 ± 7.60). As the score of craving and dependency profile index total (addictive severity) increased, they had more eveningness chronotype scores. The mean score of craving and Beck depression was higher in patients with relapse than those in remission. CONCLUSIONS: Our findings, showing that relapsed patients have more eveningness chronotypes and SUD patients have less morning chronotypes than the general population, suggest that chronotypes play a role in the onset, prevention and treatment outcome of SUD and social rhythm therapy in the form of conversion to morning chronotype can achieve better remission rates. Our study also inspires studies to be conducted in larger samples investigating the role of having a morning chronotype in protection from the SUD.