Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Laboratório de Cronobiologia do Hospital de Clínicas de Porto Alegre (HCPA), Brazil.
Chronobiol Int. 2011 Nov;28(9):771-8. doi: 10.3109/07420528.2011.602445. Epub 2011 Sep 6.
In public health, mood disorders are among the most important mental impairments. Patients with depressive episodes exhibit daily mood variations, abnormal patterns in sleep-wake behavior, and in the daily rhythms of several endocrine-metabolic parameters. Although the relationship between the sleep/circadian processes and mood disorders is poorly understood, clock-related therapies, such as light therapy, sleep deprivation, and rigid sleep schedules, have been shown to be effective treatments. Several studies investigated the relationship between circadian phenotype (chronotype) and depression. These focused mainly on urban populations and assessed diurnal preferences (Morningness-Eveningness score) rather than the actual timing of sleep and activity. Here, we used the Beck Depression Inventory (BDI) in an essentially rural population (N?=?4051), and investigated its relation to circadian phenotype (chronotype and social jetlag), assessed with the Munich Chronotype Questionnaire (MCTQ). In our study design, we (i) normalized both chronotype and BDI scores for age and sex (MSF(sas) and BDI(as), respectively); (ii) calculated individual social jetlag (misalignment of the biological and social time); and (iii) investigated the relationship between circadian phenotypes and BDI scores in a population homogeneous in respect to culture, socioeconomic factors, and daily light exposure. A 15.65% (N?=?634) of the participants showed mild to severe depressive BDI scores. Late chronotypes had a higher BDI(as) than intermediate and early types, which was independent of whether or not the participants were smokers. Both chronotype and BDI(as) correlated positively with social jetlag. BDI(as) was significantly higher in subjects with >2?h of social jetlag than in the rest of the population?again independent of smoking status. We also compared chronotype and social jetlag distributions between BDI categories (no symptoms, minimal symptoms, and mild to severe symptoms of depression) separately for men and women and for four age groups; specifically in the age group 31?40 yrs, subjects with mild to severe BDI scores were significantly later chronotypes and suffered from higher social jetlag. Our results indicate that misalignment of circadian and social time may be a risk factor for developing depression, especially in 31- to 40-yr-olds. These relationships should be further investigated in longitudinal studies to reveal if reduction of social jetlag should be part of prevention strategies. (Author correspondence: karla.allebrandt@med.uni-muenchen.de ).
在公共卫生领域,情绪障碍是最重要的精神障碍之一。患有抑郁发作的患者表现出日常情绪变化、睡眠-觉醒行为异常以及几种内分泌代谢参数的日常节律变化。尽管睡眠/昼夜节律过程与情绪障碍之间的关系尚不清楚,但已经证明与时钟相关的治疗方法,如光照疗法、睡眠剥夺和严格的睡眠时间表,是有效的治疗方法。几项研究调查了昼夜节律表型(睡眠时型)与抑郁症之间的关系。这些研究主要集中在城市人群中,评估了昼夜偏好(晨型/晚型评分),而不是睡眠和活动的实际时间。在这里,我们使用贝克抑郁量表(BDI)对基本上是农村人口(N=4051)进行了调查,并使用慕尼黑睡眠时型问卷(MCTQ)评估了昼夜节律表型(睡眠时型和社会时差)与抑郁的关系。在我们的研究设计中,我们(i)分别对睡眠时型和 BDI 评分进行了年龄和性别标准化(MSF(sas)和 BDI(as));(ii)计算了个体社会时差(生物时间和社会时间的不匹配);(iii)在文化、社会经济因素和日常光照暴露方面同质的人群中,研究了昼夜节律表型与 BDI 评分之间的关系。15.65%(N=634)的参与者表现出轻度至重度抑郁 BDI 评分。晚型睡眠时型的 BDI(as)高于中间型和早型,无论参与者是否吸烟。睡眠时型和 BDI(as)均与社会时差呈正相关。社会时差>2 小时的受试者的 BDI(as)明显高于其他人群,同样与吸烟状态无关。我们还分别比较了男性和女性以及四个年龄组中 BDI 类别(无症状、轻度症状和中度至重度症状)之间的睡眠时型和社会时差分布;特别是在 31 至 40 岁年龄组中,具有轻度至重度 BDI 评分的受试者明显是晚型睡眠时型,并且遭受更高的社会时差。我们的研究结果表明,昼夜节律和社会时间的不匹配可能是患抑郁症的一个风险因素,尤其是在 31 至 40 岁的人群中。应在纵向研究中进一步研究这些关系,以确定是否应减少社会时差作为预防策略的一部分。(作者通讯:karla.allebrandt@med.uni-muenchen.de)
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