Circadian rhythms in depression and recovery: Evidence for blunted amplitude as the main chronobiological abnormality

Circadian rhythms of body temperature, plasma cortisol, norepinephrine (NE), thyroid stimulating hormone (TSH), and melatonin were compared in 16 endogenously depressed, 15 recovered (after 3 weeks of anti-depressant treatment), and 16 normal subjects. The depressed patients showed clear circadian rhythm abnormalities, consisting mainly in amplitude reduction. This amplitude reduction was significantly correlated with the patients' Hamilton depression scores. Normal circadian profiles were restored after recovery when amplitude, in particular, was increased. Features of the circadian rhythms observed in remission may be associated with antidepressant drug effects, whereas those observed in depression resemble the circadian rhythms observed in normal subjects living under conditions of temporal isolation and those of blind subjects. Our findings suggest that depression may be related both to a weakening of the coupling processes between internal pacemakers and to an abnormal sensitivity to environmental information.

[1]  L. Tiefenauer,et al.  Prevention of bridge binding effects in haptenic immunoassay systems exemplified by an iodinated radioimmunoassay for melatonin. , 1984, Journal of immunological methods.

[2]  B. Pfohl,et al.  Pituitary-adrenal axis rhythm disturbances in psychiatric depression. , 1985, Archives of general psychiatry.

[3]  D. Avery,et al.  Nocturnal temperature in affective disorder. , 1982, Journal of affective disorders.

[4]  A. Johnsson,et al.  Manic‐depressive states and daily temperature , 1981, Acta psychiatrica Scandinavica.

[5]  A. Lewy,et al.  Desmethylimipramine treatment increases melatonin production in humans , 1986, Biological Psychiatry.

[6]  D. Kupfer,et al.  Depression, EEG sleep, and clinical response. , 1980, Comprehensive psychiatry.

[7]  J. Aschoff.  Freerunning and Entrained Circadian Rhythms , 1981 .

[8]  J. Weeke,et al.  The 24‐hour pattern of serum TSH in patients with endogenous depression , 1980, Acta psychiatrica Scandinavica.

[9]  D. Pringuey,et al.  [Circadian rhythms of the central temperature and blood cortisol in endogenous depression]. , 1985, L'Encephale.

[10]  K. Pirke,et al.  Circadian rhythms in endogenous depression , 1985, Psychiatry Research.

[11]  F. Goodwin,et al.  Phase advance of the circadian sleep-wake cycle as an antidepressant. , 1979, Science.

[12]  F. Davis.  Ontogeny of Circadian Rhythms , 1981 .

[13]  G. Sassolas,et al.  A chronobiological study of melatonin and cortisol secretion in depressed subjects: plasma melatonin, a biochemical marker in major depression. , 1984, Biological psychiatry.

[14]  J. Waterhouse,et al.  The use of constant routines in unmasking the endogenous component of human circadian rhythms. , 1984, Chronobiology international.

[15]  P. Linkowski,et al.  24-hour profiles of adrenocorticotropin, cortisol, and growth hormone in major depressive illness: effect of antidepressant treatment. , 1987, The Journal of clinical endocrinology and metabolism.

[16]  M. Candito,et al.  24-hour profile of plasma norepinephrine in affective disorders. , 1986, Neuropsychobiology.

[17]  Hervé Rix,et al.  Effect of recovery on the cortisol circadian rhythm of depressed patients , 1988, Biological Psychiatry.

[18]  Lennart Wetterberg,et al.  Melatonin, cortisol and ACTH in patients with major depressive disorder and healthy humans with special reference to the outcome of the dexamethasone suppression test , 1985, Psychoneuroendocrinology.

[19]  H. Roffwarg,et al.  Neuroendocrine Studies of Depressive Illness* , 1976, Pharmakopsychiatrie, Neuro-Psychopharmakologie.

[20]  G. Winokur,et al.  Circadian analysis of plasma cortisol levels before and after dexamethasone administration in depressed patients. , 1984, Archives of General Psychiatry.

[21]  J. Crammer,et al.  Change in diurnal temperature rhythm in manic-depressive illness. , 1976, British medical journal.

[22]  P. Linkowski,et al.  Thyrotropin nyctohemeral pattern in primary depression: differences between unipolar and bipolar women. , 1980, Life sciences.

[23]  D. Quinlan,et al.  Plasma cortisol levels in depression and other psychiatric disorders: a study of newly admitted psychiatric patients , 1979, Psychological Medicine.

[24]  J. Mouret,et al.  Handbook of behavioral neurobiology. Vol. 4. Biological rhythms Jürgen Aschoff. Plenum Press, New York, 1981. ISBN 0-306-40585-7. Price not given. , 1983, Neuropsychologia.

[25]  J. Amsterdam,et al.  Patterns of melatonin rhythms in depression. , 1986, Journal of neural transmission. Supplementum.

[26]  J. Arendt,et al.  Alleviation of jet lag by melatonin: preliminary results of controlled double blind trial. , 1986, British medical journal.

[27]  C. Pilapil,et al.  Circadian rhythm of plasma melatonin in endogenous depression , 1984, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[28]  F. Goodwin,et al.  Urinary 3-methoxy-4-hydroxyphenylglycol circadian rhythm. Early timing (phase-advance) in manic-depressives compared with normal subjects. , 1980, Archives of general psychiatry.

[29]  W. Engelmann,et al.  Effect of Lithium Carbonate on Circadian Periodicity in Humans , 1979, Pharmakopsychiatrie, Neuro-Psychopharmakologie.

[30]  G. Chazot,et al.  Rapid antidepressant activity of destyr gamma endorphin: Correlation with urinary melatonin , 1985, Biological Psychiatry.

[31]  L. Wetterberg,et al.  MELATONIN AND CORTISOL LEVELS IN PSYCHIATRIC ILLNESS , 1982, The Lancet.

[32]  L. Wetterberg,et al.  Twenty‐four‐hour serum levels of TSH in affective disorders , 1984, Acta psychiatrica Scandinavica.

[33]  Torbjörn Åkerstedt,et al.  Melatonin excretion, body temperature and subjective arousal during 64 hours of sleep deprivation , 1979, Psychoneuroendocrinology.

[34]  L Wetterberg,et al.  Circadian rhythms in melatonin and cortisol secretion in depression. , 1984, Advances in biochemical psychopharmacology.

[35]  G. Cornelissen,et al.  Construction of rhythm-specified reference intervals and regions, with emphasis on 'hybrid' data, illustrated for plasma cortisol. , 1983, Chronobiologia.

[36]  M. Hamilton.  A RATING SCALE FOR DEPRESSION , 1960, Journal of neurology, neurosurgery, and psychiatry.

[37]  Jürgen Aschoff,et al.  The Circadian System of Man , 1979 .

[38]  R. Post,et al.  Biological and behavioral effects of one night's sleep deprivation in depressed patients and normals. , 1979, Journal of psychiatric research.

[39]  A. Keith.  Fatty acid metabolism in D. melanogaster: formation of palmitoleate. , 1967, Life sciences.

[40]  T. Cooper,et al.  Plasma Levels of Catecholamines and Dihydroxyphenylglycol during Antidepressant Drug Treatment , 1983, Journal of clinical psychopharmacology.

[41]  Wever Ra.  Phase shifts of human circadian rhythms due to shifts of artificial Zeitgebers. , 1980 .

[42]  D. Kripke,et al.  Lithium slows rat circadian activity rhythms. , 1980, Life sciences.

[43]  J. Nurnberger,et al.  Supersensitivity to light: possible trait marker for manic-depressive illness. , 1985, The American journal of psychiatry.

[44]  G. Asnis,et al.  Cortisol secretion in endogenous depression. I. Basal plasma levels. , 1985, Archives of general psychiatry.

[45]  C. Pittendrigh.  Circadian Systems: Entrainment , 1981 .

[46]  F. Goodwin,et al.  Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. , 1984, Archives of general psychiatry.

[47]  D. Pringuey,et al.  Antidepressant effects of the sleep/wake cycle phase advance. Preliminary report. , 1987, Journal of affective disorders.

[48]  D. Pickar,et al.  Plasma norepinephrine level in affective disorders. Relationship to melancholia. , 1985, Archives of general psychiatry.

[49]  T. Wehr,et al.  Deficient nocturnal surge of TSH secretion during sleep and sleep deprivation in rapid-cycling bipolar illness , 1988, Psychiatry Research.

[50]  M. Rao,et al.  Influence of the pineal gland on pituitary function in humans , 1987, Psychoneuroendocrinology.

[51]  C. Kirkegaard,et al.  Circadian variation of serum thyrotropin in endogenous depression , 1982, Psychiatry Research.

[52]  P. Linkowski,et al.  The 24-hour profile of adrenocorticotropin and cortisol in major depressive illness. , 1985, The Journal of clinical endocrinology and metabolism.

[53]  D. Pringuey,et al.  The circadian rhythm of plasma thyrotropin in depression and recovery. , 1986, Chronobiology international.

[54]  F. Goodwin,et al.  Urinary 3-methoxy-4-hydroxyphenylglycol and major affective disorders. A replication and new findings. , 1984, Archives of general psychiatry.

[55]  F. Goodwin,et al.  Cerebrospinal fluid norepinephrine in affective illness. , 1978, The American journal of psychiatry.