期刊
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
卷 103, 期 19, 页码 7414-7419出版社
NATL ACAD SCIENCES
DOI: 10.1073/pnas.0602425103
关键词
chronobiology; circadian rhythms; melatonin; seasonal affective disorder; dim light melatonin onset (DLMO)
资金
- NCRR NIH HHS [K23 RR017636, K23 RR017636-01, M01 RR000334, 5M01 RR000334] Funding Source: Medline
- NIA NIH HHS [R01 AG021826, R01 AG21826] Funding Source: Medline
- NICHD NIH HHS [R01 HD42125, R01 HD042125] Funding Source: Medline
- NIMH NIH HHS [R01 MH55703, R01 MH056874, R01 MH56874] Funding Source: Medline
The following test of the circadian phase-shift hypothesis for patients with winter depression (seasonal affective disorder, or SAD) uses low-dose melatonin administration in the morning or afternoon/evening to induce phase delays or phase advances, respectively, without causing sleepiness. Correlations between depression ratings and circadian phase revealed a therapeutic window for optimal alignment of circadian rhythms that also appears to be useful for phase-typing SAD patients for the purpose of administering treatment at the correct time. These analyses also provide estimates of the circadian component of SAD that may apply to the antidepressant mechanism of action of appropriately timed bright light exposure, the treatment of choice. SAD may be the first psychiatric disorder in which a physiological marker correlates with symptom severity before, and in the course of, treatment in the same patients. The findings support the phase-shift hypothesis for SAD, as well as suggest a way to assess the circadian component of other psychiatric, sleep, and chronobiologic disorders.
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