Biological Rhythms in Postpartum Depression

描述(申请人提供)：我们的假设是，昼夜节律改变(褪黑素、睡眠/活动/光照、催乳素、皮质醇、促甲状腺激素-TSH)是产后抑郁症的特征。这一假说基于可检验理论，即产后迅速变化的生殖激素(雌二醇、孕酮、卵泡刺激素-FSH、黄体生成素-黄体生成素)会导致昼夜节律的幅度、相位(时间)或时间组织的紊乱，从而导致易患抑郁的女性情绪低落。特别是，褪黑素和催乳素的幅度和相位以及它们的时间关系都发生了变化。确定昼夜节律调节中的异常可以作为在未来研究中开发特定的时间生物学或其他治疗方式的基础。产后严重的抑郁症可能会对母亲和家庭造成残疾，并损害儿童的生长和神经认知发展。迫切需要对其发病机制进行调查，最终目的是开发新的治疗策略，特别是考虑到对哺乳期妇女记录的安全和有效的治疗选择的限制。为了评估昼夜节律的幅度、相位或时间组织的改变是否区分产后正常对照(NC)妇女和产后抑郁症患者(DP)，我们检测了100名未服用药物的产后妇女、50名非精神病单极妇女(根据DSM-IV标准，其主要抑郁发作(MDE)发生在产后前3个月)和50名健康NC受试者的血浆褪黑素、睡眠/觉醒和光照周期，以及催乳素、皮质醇和TSH与情绪和生殖激素的关系。我们假设产后DP的昼夜节律与NC妇女相比，将表现出异常的幅度、相位或时间关系。这项研究将作为未来研究的基础，在未来的研究中，旨在纠正这些潜在的昼夜节律异常的治疗方法，并将它们恢复到NC妇女的昼夜节律异常，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.