Maximum nocturnal serum melatonin level (MTmax) in relation to some clinical variables was studied in 32 patients with a major depressive episode and in 33 healthy subjects with reference to the outcome of the dexamethasone suppression test (DST). Significant regressions were found between MTmax levels and clinical rating scores in CPRS, interpreted as retardation symptoms. Four healthy subjects with disposition for dysthymic reactions had subnormal MTmax levels, which differed from MTmax levels in subjects without such disposition. Patients but not the healthy subjects, who reported parental loss before 17 years of age, had subnormal MTmax levels and differed from patients with no reported parental loss. Patients with no reported suicidal behaviour in clinical history had significantly lower MTmax levels than patients with reported suicide attempts. No relations were found between low MTmax levels and diagnoses, duration of illness, reported inheritance for depressive illness or sleep disturbances. A hypothetical low melatonin syndrome in depression is proposed: low nocturnal melatonin, abnormal dexamethasone suppression test, disturbed 24-h rhythm of cortisol, less pronounced daily and annual cyclic variation in depressive symptomatology.

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Morning (0800) plasma and serum and mean diurnal (24-h) serum calcium (Ca) and magnesium (Mg) concentrations were investigated in 56 depressed patients, 32 with acute major depression, 26 of these restudied in remission, 24 patients with longstanding depression, mainly treated with lithium, and in 27 healthy controls. All subjects were rated with the Comprehensive Psychopathological Rating Scale (CPRS). Significant differences between the groups were found for 0800 and 24-h serum Ca and Mg, 0800 plasma Mg, but not for 0800 plasma Ca. Elevations of serum Ca and Mg, plasma Mg but not plasma Ca were noted in the lithium-treated patients. Sex differences for plasma but not serum levels were seen in remission and in the controls. Depressive symptoms were negatively correlated to 0800 plasma Ca in the acute state and positively to 0800 and 24-h serum Ca and Mg in remission and longstanding depression. This difference between plasma and serum in relation to symptoms could reflect a change in a calcium binding factor present in plasma but not in serum, connected with biological factors of affective disease.