Swanson Leslie M, Burgess Helen J, Huntley Edward D, Bertram Holli, Mooney Ann, Zollars Jennifer, Dopp Richard, Hoffmann Robert, Armitage Roseanne, Todd Arnedt J
Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
Rush University Medical Center, Chicago, IL, United States.
Psychiatry Res. 2017 Jun;252:262-269. doi: 10.1016/j.psychres.2017.03.010. Epub 2017 Mar 8.
Few studies have examined relationships between circadian rhythms and unipolar major depressive disorder. Further, no study to date has examined circadian markers as predictors of response to depression treatment. In the present study, we examined associations between circadian timing and its alignment with sleep and depression severity in 30 adults with major depressive disorder who completed a randomized controlled trial of two weeks of time in bed (TIB) restriction administered adjunctive to fluoxetine, with a focus on sex differences. Thirty adults with major depressive disorder received 8 weeks of fluoxetine 20-40 mgs and were randomized to 8h TIB or 6h TIB for the first 2 weeks. Participants in the 6h TIB condition were further randomized to a delayed bedtime or advanced risetime group. Circadian measures included dim light melatonin onset (DLMO) and the difference between DLMO and midsleep point (i.e., phase angle difference). Depression was assessed using the Hamilton Rating Scale for Depression. For females, a phase delay after 2 weeks of fluoxetine and the experimental TIB manipulation was associated with a poorer response to fluoxetine, and depression severity was negatively correlated with phase angle difference, whereas males showed a positive correlation between depression severity and phase angle difference.
很少有研究探讨昼夜节律与单相重度抑郁症之间的关系。此外，迄今为止，尚无研究将昼夜节律标志物作为抑郁症治疗反应的预测指标。在本研究中，我们对30名患有重度抑郁症的成年人进行了研究，这些成年人完成了一项随机对照试验，该试验将两周卧床时间（TIB）限制作为氟西汀辅助治疗手段，并重点关注性别差异，研究了昼夜节律时间及其与睡眠和抑郁严重程度的一致性之间的关联。30名患有重度抑郁症的成年人接受了8周20 - 40毫克的氟西汀治疗，并在前两周被随机分为8小时TIB组或6小时TIB组。6小时TIB组的参与者进一步被随机分为晚睡组或早起组。昼夜节律测量指标包括暗光褪黑素起始时间（DLMO）以及DLMO与睡眠中点之间的差异（即相位角差）。使用汉密尔顿抑郁量表评估抑郁情况。对于女性，氟西汀治疗2周及实验性TIB操作后出现相位延迟与对氟西汀的反应较差有关，且抑郁严重程度与相位角差呈负相关，而男性的抑郁严重程度与相位角差呈正相关。
