National Institute of Psychiatry, Mexico.
J Affect Disord. 2009 Dec;119(1-3):100-6. doi: 10.1016/j.jad.2009.02.021. Epub 2009 Mar 13.
Rhythm disturbances are a frequent clinical manifestation of depression. In recent years a possible relationship between depression and chronotypes has emerged. Specifically eveningness has been proposed as vulnerability factor. The aim of this study was to describe sleep features of depressed patients according to chronotypes and to explore possible associations with the clinical features of depressive episodes.
100 patients diagnosed with Major Depressive Disorder according to the Mini International Neuropsychiatric Interview (MINI) were included (age: 34+/-11.74, range: 18-60 years; female/male:79/21). At admission the Hamilton Rating Scale for Depression (HRSD) was administered. Patients were also administered the Morningness-Eveningness Questionnaire (MEQ), the Epworth Sleepiness Scale, the Athens Insomnia Scale and the Pittsburgh Sleep Quality Index.
According to MEQ scores patients were classified in three groups: a) eveningness (n=18), b) neither (n=61) and c) morningness type (n=21). The age was different among chronotypes, being morningness-type patients older. The eveningness-type group showed higher scores in suicidal thoughts, more impaired work and activities, higher paranoid symptoms, higher scores on the anxiety cluster (HRSD), while the morningness-type group showed lower proportion of melancholic symptoms (MINI). We did not find association between sleep parameters and specific chronotypes.
The relatively small sample size and the concurrent assessment of chronotypes and depression may have biased our findings.
Our data suggest the idea that chronotypes have an impact on depressive episodes features, with higher severity for the eveningness-type.
节律紊乱是抑郁症的常见临床表现。近年来，抑郁与昼夜类型之间可能存在关联。具体而言，晚睡被认为是一种脆弱性因素。本研究旨在根据昼夜类型描述抑郁患者的睡眠特征，并探讨其与抑郁发作临床特征的可能关联。
本研究共纳入 100 例符合《Mini 国际神经精神访谈》（MINI）诊断标准的重性抑郁障碍患者（年龄：34+/-11.74 岁，范围：18-60 岁；女性/男性：79/21）。入院时，使用汉密尔顿抑郁评定量表（HRSD）进行评估。患者还接受了晨晚问卷（MEQ）、Epworth 嗜睡量表、雅典失眠量表和匹兹堡睡眠质量指数的评估。
根据 MEQ 评分，患者被分为三组：a）晚睡型（n=18），b）中间型（n=61）和 c）早醒型（n=21）。不同昼夜类型之间的年龄存在差异，早醒型患者年龄较大。晚型组自杀观念得分较高，工作和活动能力受损更严重，偏执症状更严重，焦虑症状群得分更高（HRSD），而早醒型组出现忧郁症状的比例较低（MINI）。我们未发现睡眠参数与特定昼夜类型之间存在关联。
样本量相对较小，以及同时评估昼夜类型和抑郁可能会影响我们的研究结果。
我们的数据表明，昼夜类型对抑郁发作的特征有影响，晚型抑郁的严重程度更高。
