Biological Rhythms in Postpartum Depression

描述（由申请人提供）：我们的假设是改变的昼夜节律（褪黑激素、睡眠/活动/照明、催乳素、皮质醇、促甲状腺激素- tsh）是产后抑郁症女性的特征。这一假设是基于一个可测试的理论，即产后快速变化的生殖激素（雌二醇、黄体酮、促卵泡激素- fsh、黄体生成素- lh）会导致昼夜节律的振幅、阶段（时间）或时间组织紊乱，从而导致易感女性的抑郁情绪。特别是，褪黑素和催乳素的振幅和相位，以及它们的时间关系，被改变。识别昼夜节律调节中的异常可以作为未来研究中开发特定时间生物学或其他治疗方式的基础。产后重度抑郁症会对母亲和家庭造成致残影响，并损害儿童的成长和神经认知发展。迫切需要对其发病机制进行调查，最终目的是制定新的治疗策略，特别是考虑到在哺乳期妇女中记录的安全有效的治疗方案的局限性。为了评估昼夜节律的变化幅度、相位或时间组织是否能区分产后抑郁症患者（DP）与产后正常对照（NC）女性，我们将检测100名未服药的产后女性、50名非精神病性单极女性的血浆褪黑素、睡眠/觉醒和光照周期、催乳素、皮质醇和TSH与情绪和生殖激素的关系。根据DSM-IV标准在产后前3个月内出现重度抑郁发作（MDE）的患者，以及50名年龄、产后周数和母乳喂养状况相匹配的健康NC受试者。我们假设产后DP的昼夜节律与NC女性相比，会表现出异常的幅度、相位或时间关系。这项研究将作为未来研究的基础，这些研究旨在纠正这些潜在的昼夜节律异常，并将其恢复到NC女性的水平，从而改善DP患者的情绪。

DESCRIPTION (provided by applicant): Our hypothesis is that altered circadian rhythms (melatonin, sleep/activity/illumination, prolactin, cortisol, thyroid stimulating hormone-TSH) characterize women with postpartum depression. This hypothesis is based on the testable theory that rapidly changing reproductive hormones (estradiol, progesterone, follicle stimulating hormone-FSH, luteinizing hormone-LH') during the postpartum period precipitate disturbances in the amplitude, phase (timing') or temporal organization of circadian rhythms that contribute to depressed mood in predisposed women. In particular, melatonin and prolactin amplitude and phase, and their temporal relationship, are altered. Identifying abnormalities in the regulation of circadian rhythms can serve as a basis for developing specific chronobiological or other treatment modalities in future studies. Postpartum major depression can have disabling effects on the mother and family and impair the growth and neurocognitive development of the child. Investigation into its pathogenesis, with the ultimate aim of developing new treatment strategies, is needed urgently, particularly given limitations on the safe and effective treatment options documented in lactating women. To assess whether alterations in amplitude, phase or temporal organization of circadian rhythms distinguish postpartum depressed patients (DP) from postpartum normal control (NC) women, we will examine plasma melatonin, the sleep/wake and illumination cycle, and prolactin, cortisol, and TSH in relationship to mood and reproductive hormones in 100 unmedicated postpartum women, 50 non-psychotic, unipolar women, whose onset of a major depressive episode (MDE) by DSM-IV criteria occurs during the first 3 months postpartum, and 50 healthy NC subjects, matched for age, postpartum week, and breast-feeding status. We hypothesize that the circadian rhythms of postpartum DP, compared with NC women, will exhibit abnormal amplitude, phase or temporal relationships. This study would serve as the basis of future studies in which treatments designed to correct these underlying abnormalities in circadian rhythms, and restore them to those of NC women, thereby would improve mood in DP.