Suzuki Masahiro, Dallaspezia Sara, Locatelli Clara, Lorenzi Cristina, Uchiyama Makoto, Colombo Cristina, Benedetti Francesco
Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy; Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan.
Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
J Affect Disord. 2017 Mar 1;210:14-18. doi: 10.1016/j.jad.2016.12.007. Epub 2016 Dec 13.
The discrepancy between subjective and objective severity of depressive syndromes has been proposed as a predictor of treatment outcome and suicidal risk in depression, and is associated with depressive cognitive distortions. A recent study reported that evening-type depressed patients showed higher depressive cognitions than morning-type patients. Therefore, it can be hypothesized that genetic factors affecting evening preference, such as carrying of the CLOCK rs1801260*C allele, may influence the discrepancy.
We tested this hypothesis in 132 patients affected by a major depressive episode in the course of bipolar disorder. The severity of depression was evaluated using self-rated (Beck Depression Inventory: BDI) and observer-rated (Hamilton Depression Rating Scale: HDRS) measures. The BDI-HDRS discrepancy score was calculated and the effects of the rs1801260 polymorphism on this score and on depressive cognitive distortions, as measured on the Cognitions Questionnaire, were examined.
The rs1801260*C carriers showed higher BDI-HDRS discrepancy scores than T/T homozygotes. Mediation analysis using bootstrapping procedures revealed that the dimension of depressive cognition "hopelessness" fully mediates the association between the rs1801260 polymorphism and the BDI-HDRS discrepancy.
Many gene polymorphisms other than CLOCK rs1801260 may also influence the BDI-HDRS discrepancy and depressive cognitive distortions.
Our current results suggest that factors affecting the biological clock can influence the "non-clock" psychopathological features of mood disorders.
抑郁综合征主观严重程度与客观严重程度之间的差异已被提出作为抑郁症治疗结果和自杀风险的预测指标，并且与抑郁认知扭曲有关。最近一项研究报告称，晚睡型抑郁症患者比早起型患者表现出更高的抑郁认知。因此，可以假设影响晚睡倾向的遗传因素，如携带CLOCK基因rs1801260*C等位基因，可能会影响这种差异。
我们在132例双相情感障碍伴重度抑郁发作的患者中检验了这一假设。使用自评（贝克抑郁量表：BDI）和他评（汉密尔顿抑郁评定量表：HDRS）方法评估抑郁严重程度。计算BDI-HDRS差异得分，并检验rs1801260多态性对该得分以及对认知问卷所测量的抑郁认知扭曲的影响。
rs1801260*C携带者的BDI-HDRS差异得分高于T/T纯合子。使用自助法进行的中介分析表明，抑郁认知维度“绝望感”完全中介了rs1801260多态性与BDI-HDRS差异之间的关联。
除了CLOCK基因rs1801260之外，许多其他基因多态性也可能影响BDI-HDRS差异和抑郁认知扭曲。
我们目前的结果表明，影响生物钟的因素可以影响情绪障碍的“非生物钟”精神病理特征。
