The circadian basis of winter depression
The circadian basis of winter depression
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DOI：
10.1073/pnas.0602425103
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发表时间：
2006-05-09
影响因子：
11.1
通讯作者：
Bauer, Vance K.
中科院分区：
文献类型：
--
作者：
Lewy, Alfred J.;Lefler, Bryan J.;Bauer, Vance K.
以下对冬季抑郁症（季节性情感障碍，SAD）患者的昼夜节律相移假说的测试是在早上或下午/晚上服用低剂量褪黑激素，分别诱导时相延迟或时相提前，而不引起困倦。抑郁症评分与昼夜节律相位之间的相关性揭示了昼夜节律最佳调整的治疗窗口，这似乎也有助于对 SAD 患者进行相位分型，以便在正确的时间进行治疗。这些分析还提供了对 SAD 昼夜节律组成的估计，这可能适用于适当定时的强光照射的抗抑郁作用机制，即治疗选择。 SAD 可能是第一种精神疾病，其中生理标志物与同一患者治疗前和治疗过程中的症状严重程度相关。这些发现支持了 SAD 的相移假说，并提出了一种评估其他精神、睡眠和时间生物学疾病的昼夜节律成分的方法。
The following test of the circadian phase-shift hypothesis for patients with winter depression (seasonal affective disorder, or SAD) uses low-dose melatonin administration in the morning or afternoon/evening to induce phase delays or phase advances, respectively, without causing sleepiness. Correlations between depression ratings and circadian phase revealed a therapeutic window for optimal alignment of circadian rhythms that also appears to be useful for phase-typing SAD patients for the purpose of administering treatment at the correct time. These analyses also provide estimates of the circadian component of SAD that may apply to the antidepressant mechanism of action of appropriately timed bright light exposure, the treatment of choice. SAD may be the first psychiatric disorder in which a physiological marker correlates with symptom severity before, and in the course of, treatment in the same patients. The findings support the phase-shift hypothesis for SAD, as well as suggest a way to assess the circadian component of other psychiatric, sleep, and chronobiologic disorders.