Bouhuys A L
Department of Biological Psychiatry, University Psychiatric Clinic, Groningen, The Netherlands.
Biol Psychiatry. 1991 Mar 15;29(6):600-12. doi: 10.1016/0006-3223(91)90095-4.
It is hypothesized that in depressed patients diurnal variation in mood (DV) is a daily recurring phenomenon, which fails to achieve expression on all days (showing a random distribution of DVs). From this perspective a meta-analysis was performed on the raw data of earlier presented studies. The effect of total sleep deprivation (TSD) on mood was examined in 14 so-called prototypical patients, showing on three successive days either positive DVs (feeling better in the evening) or inverse DVs. It was hypothesized that under baseline conditions mood follows a monotonous course with switching points at 7 AM and 11 PM and that during the TSD night the 7-AM switch took place earlier. The position of this switch was calculated, assuming that (1) before the switch the curve ran parallel to the nightly baseline curves, and (2) after the switch the curve showed a monotonous change parallel to the daily baseline curves. The best fit between predicted and measured depression after TSD was found for a switch at 3 AM, varying the switching point during the TSD night with hourly intervals. The characteristics based on prototypical patients contributed significantly to the prediction of the morning and the afternoon depression levels after TSD in a group of 53 patients (prototypical and nonprototypical).
据推测，抑郁症患者的情绪日变化（DV）是一种每日反复出现的现象，但并非每天都会出现（表现为DV的随机分布）。从这个角度出发，对先前研究的原始数据进行了荟萃分析。在14名所谓的典型患者中研究了完全睡眠剥夺（TSD）对情绪的影响，这些患者连续三天呈现正向DV（晚上感觉更好）或反向DV。据推测，在基线条件下，情绪呈单调变化，在上午7点和晚上11点有转折点，并且在TSD当晚，上午7点的转折点会提前出现。通过假设（1）转折点之前曲线与夜间基线曲线平行，以及（2）转折点之后曲线呈现与每日基线曲线平行的单调变化，来计算这个转折点的位置。通过以每小时为间隔改变TSD当晚的转折点，发现凌晨3点的转折点在预测和测量TSD后的抑郁情况时拟合度最佳。基于典型患者的特征对53名患者（典型和非典型）组中TSD后的上午和下午抑郁水平的预测有显著贡献。
