Varinthra Peeraporn, Liu Ingrid Y
Institute of Medical Sciences, College of Medicine, Tzu Chi University, Hualien, Taiwan.
Tzu Chi Med J. 2019 Apr-Jun;31(2):67-72. doi: 10.4103/tcmj.tcmj_181_18.
Depression is a life-threatening psychiatric disorder and a major public health concern worldwide with an incidence of 5% and a lifetime prevalence of 15%-20%. It is related with the social disability, decreased quality of life, and a high incidence of suicide. Along with increased depressive cases, health care cost in treating patients suffering from depression has also surged. Previous evidence have reported that depressed patients often exhibit altered circadian rhythms. Circadian rhythm involves physical, mental, and behavioral changes in a daily cycle, and is controlled by the suprachiasmatic nucleus of the hypothalamus in responding to light and darkness in an environment. Circadian rhythm disturbance in depressive patients causes early morning waking, sleep disturbances, diurnal mood variation, changes of the mean core temperature, endocrine release, and metabolic functions. Many medical interventions have been used to treat depression; however, several adverse effects are noted. This article reviews the types, causes of depression, mechanism of circadian rhythm, and the relationship between circadian rhythm disturbance with depression. Pharmaceutical and alternative interventions used to treat depressed patients are also discussed.
抑郁症是一种危及生命的精神障碍，是全球主要的公共卫生问题，发病率为5%，终生患病率为15%-20%。它与社会功能障碍、生活质量下降以及高自杀率相关。随着抑郁症病例的增加，治疗抑郁症患者的医疗费用也大幅飙升。先前的证据表明，抑郁症患者常常表现出昼夜节律改变。昼夜节律涉及每日周期中的身体、心理和行为变化，并由下丘脑的视交叉上核控制，以响应环境中的光照和黑暗。抑郁症患者的昼夜节律紊乱会导致早醒、睡眠障碍、日间情绪变化、平均核心体温变化、内分泌释放和代谢功能改变。许多医学干预措施已被用于治疗抑郁症；然而，也注意到了一些不良反应。本文综述了抑郁症的类型、病因、昼夜节律机制以及昼夜节律紊乱与抑郁症之间的关系。还讨论了用于治疗抑郁症患者的药物和替代干预措施。
