Istituto Scientifico Ospedale San Raffaele, Department of Clinical Neurosciences, San Raffaele Turro, Milano, Italy.
Curr Psychiatry Rep. 2009 Dec;11(6):488-93. doi: 10.1007/s11920-009-0074-1.
Sleep disturbances and dysregulation of circadian rhythms are core elements of bipolar disorder that might be involved in its pathogenesis. It has been proposed that patients with bipolar disorder have an abnormally shifted or arrhythmic circadian system and that the disturbance of circadian rhythms may be caused by an alteration in the circadian clock machinery. Chronotherapeutic strategies based on controlled exposures to environmental stimuli that act on biological rhythms have shown good efficacy in the treatment of illness episodes, thus confirming ex juvantibus the clinical relevance of internal timing in this illness.
睡眠障碍和昼夜节律失调是双相情感障碍的核心要素，可能参与其发病机制。有人提出，双相情感障碍患者的昼夜节律系统存在异常移位或节律紊乱，而昼夜节律的紊乱可能是由于昼夜节律钟机制的改变所致。基于受控暴露于作用于生物节律的环境刺激的时间治疗策略在治疗疾病发作方面显示出良好的疗效，从而从治疗效果上证实了这种疾病的内部计时的临床相关性。
