CHRONOBIOLOGICAL EVALUATION OF RAPID-CYCLING BIPOLAR DISORDER

数据显示，睡眠和觉醒发生的昼夜节律阶段 可以影响情绪障碍患者和正常人的情绪， 志愿者 该项目的目的是描述 这些睡眠-觉醒和昼夜节律效应对情绪调节的贡献 在快速循环双相情感障碍（RCBD）患者中， 一年内至少有四次躁狂、轻躁狂和/或抑郁发作。 的 该项目的研究包括睡眠的横断面研究， 轻躁狂和抑郁症的激素分泌; RCBD患者情绪与睡眠的关系; 强制去离子方案。 横断面研究的结果 表明褪黑激素、促甲状腺激素和皮质醇的节律随睡眠而变化 时间和持续时间的变化。 的数据 自然主义的研究表明，早晨的时代者（“时间给予者”， 夹带剂）和觉醒起着比 RCBD病理生理学中的夜间时钟和睡眠发作。 在 此外，这些研究表明，情绪的方向存在昼夜变化， 开关与RCBD患者，并证明没有 月经周期时相与情绪系统关系 患有RCBD的绝经前妇女。 在强制去离子化方案中， 病人被安排在一天28小时，持续13天， 进行评级。 由于人类的昼夜节律起搏器不能 到28小时的一天，这个协议允许系统的解离， 昼夜节律和睡眠对情绪的影响。

Data show that the circadian phase at which sleep and wakefulness occur can influence mood in both patients with mood disorders and in normal volunteers. The purpose of this project is to characterize the contributions of these sleep-wake and circadian effects to mood regulation in patients with rapid cycling bipolar disorder (RCBD), who experience at least four episodes of mania, hypomania, and/or depression in a year. The studies in this project include a cross-sectional study of sleep and hormonal secretion in hypomania and depression; naturalistic studies of the relationship between mood and sleep in patients with RCBD; and a forced desynchronization protocol. Results from the cross-sectional study show that the rhythms of melatonin, TSH, and cortisol vary with sleep timing and duration as the patients' moods cycle. Data from the naturalistic studies show that morning zeitgebers ("time-givers", entraining agents) and wake onset play a more significant role than evening zeitgebers and sleep onset in the pathophysiology of RCBD. In addition, these studies show a diurnal variation in the direction of mood switches in patients with RCBD, and demonstrate that there is no systematic relationship between menstrual cycle phase and mood in premenopausal women with RCBD. In the forced desynchronization protocol, patients are placed on a 28-hour day for thirteen days and frequent mood ratings are performed. Since the human circadian pacemaker cannot entrain to a 28-hour day, this protocol allows for the systematic dissociation of circadian and sleep-wake effects on mood.