Author's Response to Reviews Covering Letter

Title:Rotating night shifts too fast may cause anxiety, decreased attention performance and may impact prolactin levels during the daytime after night shifts-a case control study 1. The manuscript of " Rotating night shifts too fast may cause anxiety, decreased attention performance and may impact prolactin levels during the daytime after night shifts-a case control study " submitted to " BMC psychiatry " has not been published or submitted for publication elsewhere and has been approved by each author. 2. Written informed consents were obtained from all patients prior to participation in the study, which was conducted with the approval of the Ethical Committee of Kaohsiung Municipal Kai-Syuan Psychiatric Hospital. The statement appear in the Method section line131-134. 3. There were no conflicts of interest for all authors. 4. All authors have contributed significantly and are in agreement with the content of the manuscript. 5. We gave point-by-point response to the reviewers concerns. The Manuscript No. 1524847311126174 entitled " Rotating night shifts too fast may cause anxiety, decreased attention performance and may impact prolactin levels during the daytime after night shifts-a case control study " which was previously submitted to the BMC Psychiatry has been revised. The reply to the comments of reviewers sees below. Reply to Reviewer 1 comments Introduction: Comment 1. page 1 line 84:not sure what this is. not everyone is familiar with this rotation system. How is it helpful to the circadian rhythm? this section needs more to help the reader understand the distinctions among this system and other systems. Reply: We revised the introduction and methods are bellowed: 1) Background section, p. 4, line 79-85 " Shift work schedules in the medical field vary depending on a variety of conditions, including length of work hours (e.g. 8-h shifts or 12-h shifts), fixed or rotating scheduling, and duration of rotation. A slower rotation permits a worker to gradually adjust their circadian rhythm over a period of two to four weeks [1]. In faster rotation (shifting every three to five days), it is assumed that workers will maintain constant circadian rhythms in coordination with the environment [1]. A 8-h shift system with faster rotation is common in the medical field in Taiwan. " 2) Methods section, p. 6, line 120-125 " Most of the work schedules of our nurses consist of repetitive blocks of two consecutive day shifts to 12 a.m.), two night shifts (12 a.m. to 8 …