Wehr T A, Sack D, Rosenthal N, Duncan W, Gillin J C
Fed Proc. 1983 Aug;42(11):2809-14.
Clinical features of manic-depressive illness, such as diurnal variation in mood, early morning awakening, and cyclicity and seasonality of recurrences, have led to speculation that the circadian system may be involved in its pathophysiology. At least three types of circadian rhythm abnormalities have been described in such patients: blunting of circadian rhythms' amplitudes, advanced position (or even nonentrainment) of circadian rhythms' phases, and doubling of the length of the sleep-wake cycle from 24 to 48 h. Several types of experiments indicate that alterations in the timing of sleep and wakefulness relative to other circadian rhythms (i.e., changes in internal phase relationships) may trigger the onset or offset of episodes of depression and mania. Whether drugs used to treat manic-depressive illness act through their effects on the circadian system is currently being investigated. Direct manipulations of the circadian system are also being investigated as new approaches to treatment.
躁郁症的临床特征，如情绪的昼夜变化、清晨觉醒以及复发的周期性和季节性，引发了人们对于昼夜节律系统可能参与其病理生理学过程的猜测。此类患者至少已被描述出三种昼夜节律异常类型：昼夜节律振幅减弱、昼夜节律相位提前（甚至无同步），以及睡眠-觉醒周期时长从24小时翻倍至48小时。多种实验表明，睡眠和觉醒时间相对于其他昼夜节律的改变（即内相位关系的变化）可能触发抑郁和躁狂发作的开始或结束。目前正在研究用于治疗躁郁症的药物是否通过其对昼夜节律系统的作用来发挥功效。对昼夜节律系统的直接操控也正在作为新的治疗方法进行研究。
