Germain Anne, Kupfer David J
Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
Hum Psychopharmacol. 2008 Oct;23(7):571-85. doi: 10.1002/hup.964.
The aim of this article is to review progress in understanding the mechanisms that underlie circadian and sleep rhythms, and their role in the pathogenesis and treatment of depression.
Literature was selected principally by Medline searches, and additional reports were identified based on ongoing research activities in the authors' laboratory.
Many physiological processes show circadian rhythms of activity. Sleep and waking are the most obvious circadian rhythms in mammals. There is considerable evidence that circadian and sleep disturbances are important in the pathophysiology of mood disorders. Depressed patients often show altered circadian rhythms, sleep disturbances, and diurnal mood variation. Chronotherapies, including bright light exposure, sleep deprivation, and social rhythm therapies, may be useful adjuncts in non-seasonal and seasonal depression. Antidepressant drugs have marked effects on circadian processes and sleep.
Recent progress in understanding chronobiological and sleep regulation mechanisms may provide novel insights and avenues into the development of new pharmacological and behavioral treatment strategies for mood disorders.
本文旨在综述在理解昼夜节律和睡眠节律的潜在机制及其在抑郁症发病机制和治疗中的作用方面所取得的进展。
文献主要通过医学数据库检索选取,另外的报告则基于作者实验室正在进行的研究活动确定。
许多生理过程呈现出昼夜活动节律。睡眠和觉醒是哺乳动物中最明显的昼夜节律。有大量证据表明昼夜节律和睡眠障碍在情绪障碍的病理生理学中很重要。抑郁症患者常表现出昼夜节律改变、睡眠障碍和日间情绪变化。时间疗法,包括强光照射、睡眠剥夺和社会节律疗法,可能是治疗非季节性和季节性抑郁症的有用辅助手段。抗抑郁药物对昼夜节律过程和睡眠有显著影响。
在理解生物钟学和睡眠调节机制方面的最新进展可能为开发治疗情绪障碍的新药理学和行为治疗策略提供新的见解和途径。