Parry Barbara L, Fernando Martínez L, 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 Jun;10(3):197-208. doi: 10.1016/j.smrv.2005.09.004. Epub 2006 Apr 18.
This review summarizes studies of sleep and other biological rhythms in menopausal women with major depression compared with healthy control subjects. Where feasible, we focused on studies in women who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for a major depressive episode (MDE) compared with matched normal control subjects and the Staging System for Reproductive Aging in Women (STRAW) criteria. The aim was to review supporting evidence for the hypothesis that a disruption of the normal temporal relationship between sleep and other biological rhythms, such as melatonin, cortisol, thyroid stimulating hormone (TSH) or prolactin, occur during the menopausal transition. As a result, depressive disorders occur 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 menopausal depression compared with other depressive disorders related to the reproductive cycle (e.g. premenstrual dysphoric disorder or postpartum major depression), such as increased morning melatonin secretion, a specific profile of sleep and biological rhythms may distinguish healthy from depressed women during menopause. Further work is needed to characterize more fully the particular abnormalities associated with well-defined menopausal depression in order to develop treatment strategies targeted more specifically to pathogenesis.
本综述总结了与健康对照受试者相比，患有重度抑郁症的绝经后女性的睡眠及其他生物节律的研究。在可行的情况下，我们重点关注了符合《精神疾病诊断与统计手册》第四版（DSM-IV）重度抑郁发作（MDE）标准的女性与匹配的正常对照受试者以及女性生殖衰老分期系统（STRAW）标准的研究。目的是回顾支持以下假设的证据：在绝经过渡期间，睡眠与其他生物节律（如褪黑素、皮质醇、促甲状腺激素（TSH）或催乳素）之间正常的时间关系受到破坏，从而导致易感女性出现抑郁症。旨在纠正这些改变的相位（时间）或幅度异常的治疗策略，进而改善情绪。尽管与其他与生殖周期相关的抑郁症（如经前烦躁障碍或产后重度抑郁症）相比，绝经后抑郁症可能存在一些共同特征，如早晨褪黑素分泌增加，但特定的睡眠和生物节律特征可能在绝经期间区分健康女性和抑郁女性。需要进一步开展工作，以更全面地描述与明确的绝经后抑郁症相关的特定异常，从而制定更具针对性的针对发病机制的治疗策略。
