Chronotherapeutics and psychiatry: Setting the clock to relieve the symptoms
Chronotherapeutics and psychiatry: Setting the clock to relieve the symptoms
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DOI：
10.3109/15622975.2011.598389
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发表时间：
2011-09-01
影响因子：
3.1
通讯作者：
Thome, Johannes
中科院分区：
文献类型：
--
作者：
Coogan, Andrew N.;Thome, Johannes
在许多生理和行为参数中，昼夜节律是接近24小时的周期，基础昼夜节律定时系统是哺乳动物生理学中关键的稳态调节系统之一。许多常见的精神疾病与睡眠中断有关，包括常见的延迟或早相睡眠综合征，这本身可能表明这些疾病的昼夜节律失调。在本文中，我们讨论了季节性情感障碍、双相情感障碍和注意缺陷/多动障碍中昼夜节律异常的证据。这些证据表明，这些情况与生物钟的核心阶段标记（如褪黑激素或核心体温）的阶段延迟或阶段提前有关，表明在这些情况下存在昼夜节律不同步。我们还强调了改善昼夜节律失调的药理学和/或行为干预在产生症状缓解方面是有效的，这表明昼夜节律和情感系统之间存在内在联系，可以通过操纵来获得临床益处。
Circadian rhythms are near 24-h cycles in a number of physiological and behavioural parameters and the underpinning circadian timing systems is one of the key homeostatic regulatory systems in mammalian physiology. Many common psychiatric conditions are associated with disrupted sleep, including a common occurrence of delayed or advanced phase sleep syndromes, which in themselves may be indicative of dysregulated circadian timing in these disorders. In this article we discuss the evidence for abnormal circadian rhythms in seasonal affective disorder, bipolar disorder and attention deficit/hyperactivity disorder. Much of this evidence suggest that these conditions are associated with either phase delays or phase advances of core phase markers of the circadian clock such as melatonin or core body temperature, suggesting the presence of circadian desynchrony in these conditions. We also highlight findings that pharmacological and/or behavioural interventions that ameliorate circadian misalignments are efficacious in producing symptomatic relief, suggesting an intrinsic link between the circadian and affective systems that can be manipulated for clinical benefit.