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The circadian basis of winter depression

机译:冬季抑郁症的昼夜节律基础

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摘要

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.
机译:针对冬季抑郁症(季节性情感障碍或SAD)患者的昼夜节律相移假说的以下测试在早晨或下午/晚上使用低剂量的褪黑激素来分别诱发相延迟或相进展,而不会引起嗜睡。抑郁评分与昼夜节律相位之间的相关性揭示了昼夜节律最佳对准的治疗窗口,这对于SAD患者的分型也很有用,以便在正确的时间进行治疗。这些分析还提供了SAD昼夜节律成分的估计值,这些估计值可能适用于适当定时的明亮曝光(选择的治疗方法)的抗抑郁作用机理。 SAD可能是首例精神疾病,其中生理标志物与同一患者在治疗之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病,睡眠和计时生物学疾病的昼夜节律成分的方法。

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