Carpenter Joanne S, Crouse Jacob J, Shin Mirim, Tonini Emiliana, Hindmarsh Gabrielle, de Haan Zsofi, Iorfino Frank, Robillard Rebecca, Naismith Sharon, Scott Elizabeth M, Hickie Ian B
Youth Mental Health and Technology Team, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.
Sleep Research Unit, University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON, Canada.
J Biol Rhythms. 2025 Jul 15:7487304251349408. doi: 10.1177/07487304251349408.
Despite evidence for links between circadian dysfunction and mood disorders, previous research has largely reported on single biological markers of circadian alignment. The available evidence on relationships between 2 internal phase markers (e.g., dim light melatonin onset [DLMO] and peak cortisol concentration) suggests these signals may be temporally misaligned in major depressive disorder with greater misalignment associated with more severe depressive symptoms. This study aimed to examine multiple circadian phase markers to determine whether any youth with emerging mood disorders present with clear evidence of internal circadian misalignment, and whether the degree of circadian misalignment is correlated with more severe mood symptoms. Cross-sectional data from 69 youth presenting for mental health care (20.6 ± 3.8 years; 39% male) and 19 healthy controls (24.0 ± 3.6 years; 53% male) included actigraphy monitoring; overnight in-lab measurement of 3 phase markers: DLMO, salivary cortisol peak (CORT), and core body temperature nadir (TEMP); and depressive symptoms (Hamilton Depression Rating Scale). Abnormal phase angles between 2 phase markers were defined as ±2 standard deviations beyond the control mean. In those with emerging mood disorders, earlier TEMP relative to other phase markers (DLMO, CORT, sleep midpoint) was associated with higher depressive symptoms. Sixteen individuals (23%) with emerging mood disorders had abnormal phase angles between at least 1 pair of phase markers, consistent with internal misalignment of the circadian system. The internal misalignment subgroup had later DLMO on average, however presented with a diverse range of individual phase angle abnormalities. Diverse disruptions of circadian alignment occur in youth with mental ill-health. The relative timing of core body temperature and melatonin rhythms may be key circadian features linked to depressive symptoms. Longitudinal research is needed to establish whether correction of circadian misalignment is relevant to treatment of mood syndromes in youth with evidence of disrupted circadian systems.
尽管有证据表明昼夜节律功能障碍与情绪障碍之间存在联系，但先前的研究主要报道的是昼夜节律同步的单一生物学标志物。关于两种内源性相位标志物（如暗光褪黑素起始时间[DLMO]和皮质醇浓度峰值）之间关系的现有证据表明，在重度抑郁症中，这些信号可能在时间上不同步，且不同步程度越大，抑郁症状越严重。本研究旨在检查多个昼夜节律相位标志物，以确定是否有任何患有新发情绪障碍的青少年存在内源性昼夜节律不同步的明确证据，以及昼夜节律不同步的程度是否与更严重的情绪症状相关。来自69名寻求心理保健的青少年（20.6±3.8岁；39%为男性）和19名健康对照者（24.0±3.6岁；53%为男性）的横断面数据包括活动记录仪监测；在实验室过夜测量3种相位标志物：DLMO、唾液皮质醇峰值（CORT）和核心体温最低点（TEMP）；以及抑郁症状（汉密尔顿抑郁评定量表）。两种相位标志物之间的异常相位角定义为超出对照平均值±2个标准差。在患有新发情绪障碍的青少年中，相对于其他相位标志物（DLMO、CORT、睡眠中点），较早的TEMP与较高的抑郁症状相关。16名（23%）患有新发情绪障碍的青少年在至少一对相位标志物之间存在异常相位角，这与昼夜节律系统的内源性不同步一致。内源性不同步亚组的DLMO平均较晚，但呈现出各种不同的个体相位角异常。患有精神疾病的青少年存在多种昼夜节律同步的破坏。核心体温和褪黑素节律的相对时间可能是与抑郁症状相关的关键昼夜节律特征。需要进行纵向研究，以确定纠正昼夜节律不同步是否与治疗有昼夜节律系统紊乱证据的青少年情绪综合征相关。
