Top 10 Research Priorities for Mental Health and the Body Clock

One of the main objectives of the Circadian Mental Health Network is to set the research agenda in the field of mental health and circadian science; by identifying research priorities that feel the most important to experts in this area. The experts in this area include people with lived experience of mental health difficulties and/or circadian rhythm disruption, and those who support them.

To do this, the Network launched a priority setting partnership (PSP) in collaboration with the James Lind Alliance - an organisation dedicated to including the views of people with lived experience, and the carers and clinicians who support and treat them. The JLA provided guidance and support to help us undertake this PSP which would allow us to identify what the top priorities for future research would be.

We worked with several partners to ensure that we had the voices of lived experience represented at every stage of this process (see image below). We were lucky enough to work with The McPin Foundation, The Sleep Charity, Bipolar Scotland and many others to build a project Steering Group with a wide range of experiences. Our Steering Group included individuals with lived experience of mental health difficulties, circadian rhythm disruption and experience of both. We also had carers, supporters, clinicians and clinical support workers with backgrounds in helping those with lived experience of mental health difficulties and/or circadian disruption. All of this expertise was crucial for this project.

The Steering Group named the PSP "Mental Health and the Body Clock".

Summary of the PSP process we used, highlighting the input of our Steering Group

Our Steering Group helped us to design and share a public survey to collect all of the questions people had about mental health and the body clock that they wanted research to answer. After collecting over 900 questions, we had the massive job to pull these questions together, merge similar questions, reword questions to make them clear to everyone and identify if any of these questions were already well-answered by research. At every stage of this process, our Steering Group were involved and helped us eventually narrow things down to just 63 questions.

We then launched a new survey asking people to choose 10 out of those 63 questions that they felt were the most important to them. We took the results of this survey into a final workshop, bringing together even more individuals with lived experience, carers and clinicians to decide on a final Top 25 list.

The full Top 25 list can be found on our website, but we want to share the Top 10 here.

Top 10 priorities for research in mental health and the body clock

1. Does the interaction between mental health and the body clock vary by age, especially during different life stages?

2. What strategies (including medications) are effective in treating disrupted body clocks co-occurring with mental health issues? 

3. What is the relationship between the body clock and mental health in neurodivergent individuals and does body clock disruption worsen mental health in these individuals? 

4. What is the relationship between a disrupted body clock and bipolar disorder, or between a disrupted body clock and psychosis? What are the mechanisms involved in this? 

5. What societal and/or policy changes can help prevent mental health issues for, and reduce stigma towards, extreme chronotypes? 

6. What is the relationship between (peri)menopause, mental health and body clocks? 

7. How does mental trauma (e.g., grief) affect the body clock? How can this be managed? 

8. Would it be better for a person’s mental health to follow their own (natural) rhythms or to follow more typical sleep patterns and/or social patterns? 

9. What is the relationship between seasonal changes, body clocks, mental wellbeing and mental health issues? 

10. Can mental health difficulties, such as anxiety or depression, cause disruption of the body clock at a molecular level, or are these driven mainly by behavioural factors? 

These are the questions that have been identified by people with lived experience, carers and clinicians as being the priorities that future research should focus on.

We aimed to have the voices of lived experience heard throughout this process, so that we can truly say that this research agenda was set according to the experts. How did we do? Well, check out this blog by someone involved and you can make that decision: Mental health & sleep priority setting: ‘I felt appreciated for my lived experience’ | The McPin Foundation

This is super quick summary of a great deal of work that was completed by the Network team and the PSP Steering Group. If you want more detail on this process, watch this space.

We cannot say this enough, we could not have done this without the individuals who shared there expertise and experiences with us. Thank you!

Thank you to everyone who has been involved with this process, and thank you to those working to answer these questions.

If you are a researcher interested in tackling any of these research priorities, please get in touch with us. The Circadian Mental Health Network can support and collaborate with researchers working to answer these questions.

Did any of these questions surprise you? Is there a question you think is missing? Let us know!