Restricted accessResearch articleFirst published online 2022-5
The difference of disrupted rhythms of life,work and entertainment between patients with FGIDs and healthy people and their associations with psychological disorders under COVID-19 pandemic
To investigate the differences in disrupted rhythms between healthy people and patients with functional gastrointestinal disorders (FGIDs) and their associations with mood disorders during the coronavirus disease 2019 (COVID-19) pandemic.
Methods:
The rhythm scales were composed of subscales 1 and 2 for the assessment of life-work and entertainment rhythms, respectively; Zung’s Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to assess mood disorders.
Results:
A total of 671 patients with FGIDs and 4373 healthy people successfully participated. The scores of subscales 1 and 2 for patients with FGIDs were significantly higher than those for healthy people (p < .005). The SAS and SDS scores, their prevalence rates were significantly higher than those for the healthy group (all p < .001). Health status, current occupation, life-work rhythm, SDS, and SAS were independent related factors of FGIDs. The score of life-work-entertainment rhythm was significantly positively correlated with SDS and SAS (both p < .001).
Conclusion:
Disrupted rhythms in patients with FGIDs under the COVID-19 pandemic were more frequently and significantly positively associated with mood disorders.
Abautret-DalyA.DempseyE.Parra-BlancoA.MedinaC.HarkinA. (2018). Gut-brain actions underlying comorbid anxiety and depression associated with inflammatory bowel disease. Acta Neuropsychiatrica, 30(5), 275–296. https://doi.org/10.1017/neu.2017.3
2.
AdibiP.KeshteliA. H.DaghaghzadehH.RoohafzaH.PournaghshbandN.AfsharH. (2016). Association of anxiety, depression, and psychological distress in people with and without functional dyspepsia. Advanced Biomedical Research, 5(1), 195. https://doi.org/10.4103/2277-9175.190936
3.
AmerioA.BianchiD.SantiF.CostantiniL.OdoneA.SignorelliC.CostanzaA.SerafiniG.AmoreM.AgugliaA. (2020). Covid-19 pandemic impact on mental health: A web-based cross-sectional survey on a sample of Italian general practitioners. Acta Bio-medica: Atenei Parmensis, 91(2), 83–88. https://doi.org/10.23750/abm.v91i2.9619
4.
AquilaI.SaccoM. A.RicciC.GratteriS.Montebianco AbenavoliL.OlivaA.RicciP. (2020). The role of the COVID-19 pandemic as a risk factor for suicide: What is its impact on the public mental health state today?Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S120–S122. https://doi.org/10.1037/tra0000616
5.
BallouS.AlhassanE.HonE.LemboC.RanganV.SinghP.HirschW.SommersT.IturrinoJ.NeeJ.LemboA. (2018). Sleep disturbances are commonly reported among patients presenting to a gastroenterology clinic. Digestive Diseases and Sciences, 63(11), 2983–2991. https://doi.org/10.1007/s10620-018-5237-7
6.
BerensS.EngelF.GaussA.TesarzJ.HerzogW.NieslerB.Stroe-KunoldE.SchaefertR. (2020). Patients with Multiple Functional Gastrointestinal Disorders (FGIDs) Show increased illness severity: A cross-sectional study in a tertiary care FGID specialty clinic. Gastroenterology Research and Practice, 2020, 9086340. https://doi.org/10.1155/2020/9086340
7.
BioqueM.Gonzalez-RodriguezA.Garcia-RizoC.CoboJ.MonrealJ. A.UsallJ.SoriaV.LabadJ. (2021). Targeting the microbiome-gut-brain axis for improving cognition in schizophrenia and major mood disorders: A narrative review. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 105, 110130. https://doi.org/10.1016/j.pnpbp.2020.110130
BurnsG.CarrollG.MatheA.HorvatJ.FosterP.WalkerM. M.TalleyN. J.KeelyS. (2019). Evidence for local and systemic immune activation in functional dyspepsia and the irritable bowel syndrome: A systematic review. The American Journal of Gastroenterology, 114(3), 429–436. https://doi.org/10.1038/s41395-018-0377-0
10.
Codoner-FranchP.GombertM. (2018). Circadian rhythms in the pathogenesis of gastrointestinal diseases. World Journal of Gastroenterology, 24(38), 4297–4303. https://doi.org/10.3748/wjg.v24.i38.4297
DongL.BoueyJ. (2020). Public mental health crisis during COVID-19 pandemic, China. Emerging Infectious Diseases, 26(7), 1616–1618. https://doi.org/10.3201/eid2607.200407
13.
DrossmanD. A.HaslerW. L. (2016). Rome IV-functional GI disorders: Disorders of gut-brain interaction. Gastroenterology, 150(6), 1257–1261. https://doi.org/10.1053/j.gastro.2016.03.035
14.
DrossmanD. A.TackJ.FordA. C.SzigethyE.TornblomH.Van OudenhoveL. (2018). Neuromodulators for functional gastrointestinal disorders (disorders of gut-brain interaction): A Rome Foundation Working Team Report. Gastroenterology, 154(4), 1140–1171.e1. https://doi.org/10.1053/j.gastro.2017.11.279
15.
DunstanD. A.ScottN.ToddA. K. (2017). Screening for anxiety and depression: Reassessing the utility of the Zung scales. BMC Psychiatry, 17(1), 329. https://doi.org/10.1186/s12888-017-1489-6
16.
Godinho-SilvaC.DominguesR. G.RendasM.RaposoB.RibeiroH.da SilvaJ. A.VieiraA.CostaR. M.Barbosa-MoraisN. L.CarvalhoT.Veiga-FernandesH. (2019). Light-entrained and brain-tuned circadian circuits regulate ILC3s and gut homeostasis. Nature, 574(7777), 254–258. https://doi.org/10.1038/s41586-019-1579-3
HoyosC. M.GordonC.TerpeningZ.NorrieL.LewisS. J. G.HickieI. B.NaismithS. L. (2020). Circadian rhythm and sleep alterations in older people with lifetime depression: A case-control study. BMC Psychiatry, 20(1), 192. https://doi.org/10.1186/s12888-020-02606-z
19.
HoltmannG.ShahA.MorrisonM. (2017). Pathophysiology of functional gastrointestinal disorders: A holistic overview. Digestive Diseases, 35(Suppl. 1), 5–13. https://doi.org/10.1159/000485409
20.
HuangC.WangY.LiX.RenL.ZhaoJ.HuY.ZhangL.FanG.XuJ.GuX.ChengZ.YuT.XiaJ.WeiY.WuW.XieX.YinW.LiH.LiuM.CaoB. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England), 395(10223), 497–506. https://doi.org/10.1016/s0140-6736(20)30183-5
21.
HuangR. C. (2018). The discoveries of molecular mechanisms for the circadian rhythm: The 2017 Nobel Prize in Physiology or Medicine. Biomedical Journal, 41(1), 5–8. https://doi.org/10.1016/j.bj.2018.02.003
22.
HuremoviD. (2019). Psychiatry of pandemics a mental health response to infection outbreak: A mental health response to infection outbreak. Springer International Publishing.
23.
JacksonJ. L.O’MalleyP. G.TomkinsG.BaldenE.SantoroJ.KroenkeK. (2000). Treatment of functional gastrointestinal disorders with antidepressant medications: A meta-analysis. The American Journal of Medicine, 108(1), 65–72. https://doi.org/10.1016/s0002-9343(99)00299-5
24.
JonesM. P.TackJ.Van OudenhoveL.WalkerM. M.HoltmannG.KoloskiN. A.TalleyN. J. (2017). Mood and anxiety disorders precede development of functional gastrointestinal disorders in patients but not in the population. Clinical Gastroenterology and Hepatology, 15(7), 1014–1020.e4. https://doi.org/10.1016/j.cgh.2016.12.032
25.
KimH. I.JungS. A.ChoiJ. Y.KimS. E.JungH. K.ShimK. N.YooK. (2013). Impact of shiftwork on irritable bowel syndrome and functional dyspepsia. Journal of Korean Medical Science, 28(3), 431–437. https://doi.org/10.3346/jkms.2013.28.3.431
KoloskiN. A.JonesM.KalantarJ.WeltmanM.ZaguirreJ.TalleyN. J. (2012). The brain–gut pathway in functional gastrointestinal disorders is bidirectional: A 12-year prospective population-based study. Gut, 61(9), 1284–1290. https://doi.org/10.1136/gutjnl-2011-300474
28.
KoloskiN. A.JonesM.TalleyN. J. (2016). Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: A 1-year population-based prospective study. Alimentary Pharmacology & Therapeutics, 44(6), 592–600. https://doi.org/10.1111/apt.13738
29.
KonturekP. C.BrzozowskiT.KonturekS. J. (2011). Gut clock: Implication of circadian rhythms in the gastrointestinal tract. Journal of Physiology and Pharmacology, 62(2), 139–150. https://www.ncbi.nlm.nih.gov/pubmed/21673361
30.
LabusJ. S.HollisterE. B.JacobsJ.KirbachK.OezguenN.GuptaA.AcostaJ.LunaR. A.AagaardK.VersalovicJ.SavidgeT.HsiaoE.TillischK.MayerE. A. (2017). Differences in gut microbial composition correlate with regional brain volumes in irritable bowel syndrome. Microbiome, 5(1), 49. https://doi.org/10.1186/s40168-017-0260-z
31.
LaiJ.MaS.WangY.CaiZ.HuJ.WeiN.WuJ.DuH.ChenT.LiR.TanH.KangL.YaoL.HuangM.WangH.WangG.LiuZ.HuS. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
32.
LasherasI.SeralP.LatorreE.BarrosoE.Gracia-GarciaP.SantabarbaraJ. (2020). Microbiota and gut-brain axis dysfunction in autism spectrum disorder: Evidence for functional gastrointestinal disorders. Asian Journal of Psychiatry, 47, 101874. https://doi.org/10.1016/j.ajp.2019.101874
33.
LeungM.TranmerJ.HungE.KorsiakJ.DayA. G.AronsonK. J. (2016). Shift work, chronotype, and melatonin patterns among female hospital employees on day and night shifts. Cancer Epidemiology Biomarkers & Prevention, 25(5), 830–838. https://doi.org/10.1158/1055-9965.EPI-15-1178
34.
LewisM. L.PalssonO. S.WhiteheadW. E.van TilburgM. A. L. (2016). Prevalence of functional gastrointestinal disorders in children and adolescents. The Journal of Pediatrics, 177, 39–43.e3. https://doi.org/10.1016/j.jpeds.2016.04.008
35.
LiangX.FitzGeraldG. A. (2017). Timing the microbes: The circadian rhythm of the gut microbiome. Journal of Biological Rhythms, 32(6), 505–515. https://doi.org/10.1177/0748730417729066
36.
LiuY.YuanX.LiL.LinL.ZuoX.CongY.LiY. (2020). Increased ileal immunoglobulin A production and immunoglobulin A-coated bacteria in diarrhea-predominant irritable Bowel syndrome. Clinical and Translational Gastroenterology, 11(3), e00146. https://doi.org/10.14309/ctg.0000000000000146
37.
LyallL. M.WyseC. A.GrahamN.FergusonA.LyallD. M.CullenB.MoralesC. C. A.BielloS. M.MackayD.WardJ.StrawbridgeR. J.GillJ. M. R.BaileyM. E. S.PellJ. P.SmithD. J. (2018). Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: A cross-sectional study of 91 105 participants from the UK Biobank. Lancet Psychiatry, 5(6), 507–514. https://doi.org/10.1016/S2215-0366(18)30139-1
38.
MaN.ZhangJ.ReiterR. J.MaX. (2019). Melatonin mediates mucosal immune cells, microbial metabolism, and rhythm crosstalk: A therapeutic target to reduce intestinal inflammation. Medicinal Research Reviews, 40(2), 606–632. https://doi.org/10.1002/med.21628
39.
MargrafJ.LavalleeK.ZhangX.SchneiderS. (2016). Social rhythm and mental health: A cross-cultural comparison. PLoS One, 11(3), e0150312. https://doi.org/10.1371/journal.pone.0150312
40.
MasriS.Sassone-CorsiP. (2018). The emerging link between cancer, metabolism, and circadian rhythms. Nature Medicine, 24(12), 1795–1803. https://doi.org/10.1038/s41591-018-0271-8
41.
MontaigneD.MarechalX.ModineT.CoisneA.MoutonS.FayadG.NinniS.KleinC.OrtmansS.SeunesC.PotelleC.BerthierA.GheeraertC.PiveteauC.DeprezR.EeckhouteJ.DuezH.LacroixD.DeprezB.StaelsB. (2018). Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbalpha antagonism: A single-centre propensity-matched cohort study and a randomised study. The Lancet, 391(10115), 59–69. https://doi.org/10.1016/S0140-6736(17)32132-3
42.
MurrayG.GottliebJ.SwartzH. A. (2020). Maintaining daily routines to stabilize mood: Theory, data, and potential intervention for circadian consequences of COVID-19. The Canadian Journal of Psychiatry. Advance online publication https://doi.org/10.1177/0706743720957825
43.
PalssonO. S.WhiteheadW. E.van TilburgM. A.ChangL.CheyW.CrowellM. D.KeeferL.LemboA. J.ParkmanH. P.RaoS. S.SperberA.SpiegelB.TackJ.VannerS.WalkerL. S.WhorwellP.YangY. (2016). Rome IV diagnostic questionnaires and tables for investigators and clinicians. Gastroenterology, S0016–5085 (16), 00180-3. https://doi.org/10.1053/j.gastro.2016.02.014
44.
PeterJ.FournierC.DurdevicM.KnoblichL.KeipB.DejacoC.TraunerM.MoserG. (2018). A microbial signature of psychological distress in irritable Bowel syndrome. Psychosomatic Medicine, 80(8), 698–709. https://doi.org/10.1097/PSY.0000000000000630
45.
PfefferbaumB.NorthC. S. (2020). Mental health and the Covid-19 pandemic. New England Journal of Medicine, 383(6), 510–512. https://doi.org/10.1056/NEJMp2008017
46.
PilzL. K.CarissimiA.OliveiraM. A. B.FranciscoA. P.FabrisR. C.MedeirosM. S.ScopM.FreyB. N.AdanA.HidalgoM. P. (2018). Rhythmicity of mood symptoms in individuals at risk for psychiatric disorders. Scientific Reports, 8(1), 11402. https://doi.org/10.1038/s41598-018-29348-z
47.
SaeedF.SalehiM.AlaviK.AjdarkoshH.KashaninasabF.Nasr EsfahaniF. (2019). Defense mechanisms in patients with irritable bowel syndrome and their relationship with symptom severity and quality of life. Middle East Journal of Digestive Diseases, 11(3), 158–165. https://doi.org/10.15171/mejdd.2019.143
48.
SherL. (2020). The impact of the COVID-19 pandemic on suicide rates. QJM: An International Journal of Medicine, 113(10), 707–712. https://doi.org/10.1093/qjmed/hcaa202
49.
ShneiderA.KudriavtsevA.VakhrushevaA. (2020). Can melatonin reduce the severity of COVID-19 pandemic?International Reviews of Immunology, 39(4), 153–162. https://doi.org/10.1080/08830185.2020.1756284
50.
SinghR.ZoggH.WeiL.BartlettA.GhoshalU. C.RajenderS.RoS. (2021). Gut microbial dysbiosis in the pathogenesis of gastrointestinal dysmotility and metabolic disorders. Journal of Neurogastroenterology and Motility, 27(1), 19–34. https://doi.org/10.5056/jnm20149
51.
SperberA. D.BangdiwalaS. I.DrossmanD. A.GhoshalU. C.SimrenM.TackJ.WhiteheadW. E.DumitrascuD. L.FangX.FukudoS.KellowJ.OkekeE.QuigleyE. M. M.SchmulsonM.WhorwellP.ArchampongT.AdibiP.AndresenV.BenningaM. A.PalssonO. S. (2020). Worldwide prevalence and burden of functional gastrointestinal disorders, results of rome foundation global study. Gastroenterology, 160(1), 99–114.e3. https://doi.org/10.1053/j.gastro.2020.04.014
52.
TanW.HaoF.McIntyreR. S.JiangL.JiangX.ZhangL.ZhaoX.ZouY.HuY.LuoX.ZhangZ.LaiA.HoR.TranB.HoC.TamW. (2020). Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce. Brain, Behavior, and Immunity, 87, 84–92. https://doi.org/10.1016/j.bbi.2020.04.055
53.
TremblayA.LingrandL.MaillardM.FeuzB.TompkinsT. A. (2021). The effects of psychobiotics on the microbiota-gut-brain axis in early-life stress and neuropsychiatric disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 105, 110142. https://doi.org/10.1016/j.pnpbp.2020.110142
54.
VeltenJ.BiedaA.ScholtenS.WannemullerA.MargrafJ. (2018). Lifestyle choices and mental health: A longitudinal survey with German and Chinese students. BMC Public Health, 18(1), 632. https://doi.org/10.1186/s12889-018-5526-2
55.
VeltenJ.LavalleeK. L.ScholtenS.MeyerA. H.ZhangX. C.SchneiderS.MargrafJ. (2014). Lifestyle choices and mental health: A representative population survey. BMC Psychology, 2(1), 58. https://doi.org/10.1186/s40359-014-0055-y
56.
VictorG. S.AhmedS. (2019). The importance of culture in managing mental health response to pandemics. Springer.
57.
VidelockE. J.ShihW.AdeyemoM.Mahurkar-JoshiS.PressonA. P.PolytarchouC.AlbertoM.IliopoulosD.MayerE. A.ChangL. (2016). The effect of sex and irritable bowel syndrome on HPA axis response and peripheral glucocorticoid receptor expression. Psychoneuroendocrinology, 69, 67–76. https://doi.org/10.1016/j.psyneuen.2016.03.016
58.
VoigtR. M.ForsythC. B.KeshavarzianA. (2019). Circadian rhythms: A regulator of gastrointestinal health and dysfunction. Expert Review of Gastroenterology & Hepatology, 13(5), 411–424. https://doi.org/10.1080/17474124.2019.1595588
WalkerW. H.IIWaltonJ. C.DeVriesA. C.NelsonR. J. (2020). Circadian rhythm disruption and mental health. Translational Psychiatry, 10(1), 28. https://doi.org/10.1038/s41398-020-0694-0
61.
WellsM.RothL.McWilliamM.ThompsonK.ChandeN. (2012). A cross-sectional study of the association between overnight call and irritable bowel syndrome in medical students. Canadian Journal of Gastroenterology, 26(5), 281–284. https://doi.org/10.1155/2012/865915
ZhihuaG.ShaoqingY.MargrafJ.XiaochiZ. (2013). Eliability and validity for rhythm scale in Chinese. China Journal of Health Psychology, 21(8), 1219–1221.
64.
ZhouF.YuT.DuR.FanG.LiuY.LiuZ.XiangJ.WangY.SongB.GuX.GuanL.WeiY.LiH.WuX.XuJ.TuS.ZhangY.ChenH.CaoB. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. The Lancet, 395(10229), 1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3
