CIRCADIAN INTERVENTIONS IN PATIENTS WITH RAPID-CYCLING BIPOLAR DISORDER

快速循环型双相情感障碍(RCBD)患者至少经历过 一年中有四次躁狂、轻躁狂和/或抑郁发作。他们 患有严重的疾病，并经常对传统的 治疗。不稳定的睡眠/清醒周期既是 疾病和反馈的症状，从而使他们恶化。在这 在一系列项目中，我们正在探讨旨在 稳定睡眠-唤醒和昼夜节律系统具有稳定情绪的功能 对RCBD患者的影响。在RCBD患者中，我们探索了 系统研究了强光对日常生活中情绪的影响， 长周期(暗)，或外源性褪黑素，以及 急性强光或暗光对情绪的影响。我们发现慢性病 用正午强光或延长周期治疗可能会有 稳定情绪的效果；前者正在一项 对照临床试验。既不刺眼，也不昏暗，每天 晚间光照，也不是每天外源褪黑素对 RCBD患者的情绪状态。褪黑素的处方剂量为5.0或 每天10.0毫克，晚上8：00或10：00给药曾经有过 初步证据表明，早晨的光疗可能会破坏患者的情绪稳定 RCBD患者。

Patients with rapid cycling bipolar disorder (RCBD) experience at least four episodes of mania, hypomania, and/or depression in a year. They suffer significant morbidity and are frequently resistant to conventional treatments. An unstable sleep/wake cycle is both characteristic of the illness and feeds back on the symptoms so as to exacerbate them. In this series of projects, we are exploring whether interventions designed to stabilize the sleep-wake and circadian systems have mood-stabilizing effects in patients with RCBD. In patients with RCBD, we have explored systematically the effects on mood of daily treatment with bright light, extended scotoperiod (dark), or exogenous melatonin, as well as the effects on mood of acute bright or dim light. We found that chronic treatment with midday bright light or extended scotoperiod may have mood-stabilizing effects; the former is being studied further in a controlled clinical trial. Neither acute bright or dim light, daily evening light, nor daily exogenous melatonin had a significant effect on mood in patients with RCBD. Melatonin was prescribed in doses of 5.0 or 10.0 mg each day, administered at 8:00 or 10:00 p.m. There was preliminary evidence that morning phototherapy might destabilize mood in patients with RCBD.