Le Strat Y, Ramoz N, Gorwood P
Inserm U675, IFR02, faculté Xavier-Bichat, université Paris-VII, Paris, France.
Ann Pharm Fr. 2008 Jun;66(3):169-74. doi: 10.1016/j.pharma.2008.04.005. Epub 2008 Jun 20.
Disruptions of circadian rhythms are described in affective disorders, including unipolar and bipolar disorder, but also seasonal affective disorder. Sleep-wake and hormone circadian rhythms are among the most quoted examples. Depression could be conceptualized as a desynchronization between the endogenous circadian pacemaker and the exogenous stimuli, such as sunlight and social rhythms. Accordingly, Clock genes have been studied and the literature suggests that variants in these genes confer a higher risk of relapse, more sleep disturbances associated with depression, as well as incomplete treatment response. Most of therapeutic interventions in depression have an impact on biological rhythms. Some of them exclusively act via a biological pathway, such as sleep deprivation or light therapy. Some psychosocial interventions are specifically focusing on social rhythms, particularly in bipolar disorder, in which the promotion of stabilization is emphasized. Finally, all antidepressant medications could improve biological rhythms, but some new agents are now totally focusing this novel approach for the treatment of depression.
昼夜节律紊乱在情感障碍中有所描述，包括单相和双相情感障碍，还有季节性情感障碍。睡眠-觉醒和激素昼夜节律是最常被提及的例子。抑郁症可被概念化为内源性昼夜节律起搏器与外源性刺激（如阳光和社交节律）之间的不同步。因此，人们对生物钟基因进行了研究，文献表明这些基因的变异会增加复发风险、与抑郁症相关的更多睡眠障碍以及不完全的治疗反应。抑郁症的大多数治疗干预措施都会对生物节律产生影响。其中一些仅通过生物途径起作用，如睡眠剥夺或光疗。一些心理社会干预措施特别关注社交节律，尤其是在双相情感障碍中，其中强调促进病情稳定。最后，所有抗抑郁药物都可以改善生物节律，但现在一些新型药物完全专注于这种治疗抑郁症的新方法。
