Parry Barbara L, Martínez L Fernando, Maurer Eva L, López Ana M, Sorenson Diane, Meliska Charles J
Department of Psychiatry 0804, University of California-San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0804, USA.
Sleep Med Rev. 2006 Apr;10(2):129-44. doi: 10.1016/j.smrv.2005.09.003. Epub 2006 Feb 3.
This review summarizes studies of sleep and other biological rhythms during the menstrual cycle, pregnancy and the postpartum period, focusing, where feasible, on studies in women who met DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, 4th edition) criteria for a depressive disorder compared with healthy controls. The aim was to review supporting evidence for the hypothesis that disruption of the normal temporal relationship between sleep and other biological rhythms such as melatonin, core body temperature, cortisol, thyroid stimulating hormone (TSH) or prolactin occurring during times of reproductive hormonal change precipitates depressive disorders in predisposed women. Treatment strategies, designed to correct these altered phase (timing) or amplitude abnormalities, thereby improve mood. Although there may be some common features to premenstrual, pregnancy and postpartum depressive disorders (e.g. elevated prolactin levels), a specific profile of sleep and biological rhythms distinguishes healthy from depressed women during each reproductive epoch. Further work is needed to characterize more fully the particular abnormalities associated with each reproductive state to identify common versus distinctive features for each diagnostic group. This information could serve as the basis for developing more targeted treatment strategies.
本综述总结了月经周期、孕期及产后睡眠和其他生物节律的研究，在可行的情况下，重点关注符合《精神疾病诊断与统计手册》第四版（DSM-IV）抑郁症标准的女性与健康对照者的研究。目的是回顾以下假说的支持证据：在生殖激素变化时期，睡眠与其他生物节律（如褪黑素、核心体温、皮质醇、促甲状腺激素（TSH）或催乳素）之间正常的时间关系被破坏，从而使易感女性患上抑郁症。治疗策略旨在纠正这些改变的相位（时间）或幅度异常，进而改善情绪。尽管经前、孕期和产后抑郁症可能有一些共同特征（如催乳素水平升高），但在每个生殖阶段，睡眠和生物节律的特定特征可区分健康女性与抑郁女性。需要进一步开展工作，更全面地描述与每种生殖状态相关的特定异常情况，以确定每个诊断组的共同特征与独特特征。这些信息可为制定更具针对性的治疗策略提供依据。
