Summary: A study from Orygen found that young people at ultra‑high risk for psychosis who prefer evening hours reported higher levels of negative psychotic symptoms.
Source: Orygen
Key finding: Young people identified as being at ultra‑high risk for developing psychosis showed significantly greater negative psychotic symptoms when they had a stronger preference for evening activity, according to research led by Orygen.
Published in Early Intervention in Psychiatry, the study examined how sleep problems and chronotype—whether someone is a morning person or an evening person—relate to depressive and psychotic symptoms in adolescents and young adults. The research team assessed 81 participants aged 12 to 25 who had been identified as ultra‑high risk for psychosis, using clinical interviews and self‑report sleep and chronotype measures.
The main result was that participants who showed a greater preference for eveningness—often referred to as “night owls”—reported higher levels of negative psychotic symptoms. Negative symptoms can include reduced emotional expression, social withdrawal, diminished motivation, and decreased engagement in daily activities. These symptoms are often persistent and among the most challenging to treat in psychosis.
The researchers also confirmed that sleep disturbances were associated with higher depressive symptoms and with attenuated positive psychotic symptoms (subthreshold positive symptoms that can precede a psychotic disorder). However, the specific association between eveningness and negative symptoms is a novel contribution of this study.
“This is the first study to identify a relationship between chronotype and negative psychotic symptoms in an ultra‑high risk sample,” the research team notes.
Adolescence and young adulthood are critical periods for both the emergence of psychotic disorders and for shifts in sleep timing: many teenagers naturally begin to stay up later, go to bed later, and socialize in the evening. The concurrence of these developmental changes with increased vulnerability to psychotic disorders suggests chronotype changes could be an important factor to investigate further.
Study lead Dr Jessica Hartmann emphasized the importance of measuring chronotype during clinical assessment. Typically, clinicians do not ask whether a young person is a morning or evening person, yet this simple measure may help identify individuals at higher risk of deteriorating mental health and guide early intervention strategies.
Early intervention is a central aim. The authors note emerging evidence that chronotype can be modified over time, and that shifting sleep timing earlier in the day may be achievable through chronobiological and behavioral approaches. If future studies replicate the observed link between eveningness and negative symptoms, modifying chronotype could become a target for reducing these difficult‑to‑treat symptoms.
Because this was the first study to report the association between evening preference and negative symptoms in an ultra‑high risk cohort, the researchers call for replication and longitudinal research. Confirming the relationship in larger and longer studies would clarify whether eveningness contributes to worsening negative symptoms, or whether it is itself a marker of underlying processes that drive symptom development.
Funding: The research received support from the National Health and Medical Research Council of Australia and the Stanley Medical Research Institute.
About this psychosis research news
Source: Orygen
Contact: Press Office – Orygen
Image: Image credited to Orygen
Original Research: Closed access. “Greater preference for eveningness is associated with negative symptoms in an ultra‑high risk for psychosis sample” by Jessica Hartmann et al., published in Early Interventions in Psychiatry.
Abstract
Greater preference for eveningness is associated with negative symptoms in an ultra‑high risk for psychosis sample
Aim
This study explored biological and behavioral processes related to sleep and chronotype in individuals at ultra‑high risk for psychosis, with the goal of improving understanding of the mechanisms that underlie psychosis onset, refining early prediction, and guiding possible intervention strategies.
Methods
Eighty‑one ultra‑high risk participants completed clinical interviews and self‑report measures of sleep disturbances and chronotype as part of the Neurapro clinical trial. Mixed regression analyses were used to examine cross‑sectional associations between sleep measures, chronotype, and depressive and psychotic symptom ratings.
Results
Sleep disturbances were significantly associated with higher depressive symptoms and with greater attenuated positive psychotic symptoms. A stronger preference for eveningness was significantly associated with increased negative symptoms, but not with depressive symptoms or attenuated positive psychotic symptoms.
Conclusion
The findings suggest that both sleep disturbance and chronotype may influence early psychopathology in individuals at ultra‑high risk for psychosis. The preliminary link between greater evening preference and negative symptoms indicates a potential avenue for chronobiological intervention research aimed at preventing or reducing negative symptoms during this vulnerable developmental stage.