Testing the Hypothesis of a Circadian Phase Disturbance Underlying Depressive Mood in Nonseasonal Depression

Gordijn, Marijke C. M.; Beersma, Domien; Korte, H; Hoofdakker, RH van den

doi:10.1177/074873098128999989

Cited by 21 publications

(11 citation statements)

References 39 publications

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“…A study of 17 SAD patients and controls reported that light-associated temperaure decreases are in direct proportion to antidepressant responses (Schwartz et al 1997b). A review of the literature in major depression suggests that bright light therapy is not as effective for treatment of nonseasonal depression as compared with seasonal depression (Gordijn et al 1998;Thalaen et al 1997). However, some nonseasonal patients may show improvement (Dietzel et al 1986;Kripke, 1998;Yamada et al 1995).…”

Section: Bright Light Therapymentioning

confidence: 99%

Molecular Clock Genes in Man and Lower Animals Possible Implications for Circadian Abnormalities in Depression

Bunney

2000

Neuropsychopharmacology

240

150

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Section: Bright Light Therapymentioning

confidence: 99%

Molecular Clock Genes in Man and Lower Animals Possible Implications for Circadian Abnormalities in Depression

Bunney

2000

Neuropsychopharmacology

240

150

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“…Most [16][17][18][19][20][21][22][23], but not all [24,25], of these studies showed disturbed circadian temperature rhythms in patients with depression and other mood disorders [26,27]. Some [22,[28][29][30], but not all [31], studies on depressed patients have documented high nocturnal temperatures and higher mean 24-hour temperatures [28].…”

Section: Introductionmentioning

confidence: 99%

Depressed Patients Have Higher Body Temperature: 5-HT Transporter Long Promoter Region Effects

et al. 2003

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Background: Depression has been associated with a decrease in intracellular serotonin (5-HT) reuptake through its transporter, SERT. The 5-HT transporter long promoter region (5-HTTLPR) deletion in the SERT gene has also been associated with a decrease in 5-HT reuptake. Conversely, increases in extracellular 5-HT have been associated with increased temperature. It has not been established, however, whether body temperature in depressed patients is different from controls. Here, we hypothesized that temperature would be increased in depressed patients as well as in those with the 5-HTTLPR deletion. Methods: A strict oral temperature protocol employed single, cross-sectional, naturalistic time-of-day temperature measures in 125 subjects (46 normal controls, 79 outpatients with major depression). Controls and depressed patients were free of psychotropic medication and classified by the Structured Clinical Interview for Psychiatric Diagnoses. Eighty-one of the subjects (68 depressed, 13 normal) were additionally genotyped for 5-HTTLPR polymorphisms. Results: Depressed patients had a significantly higher uncorrected body temperature (mean ± SD 98.38 ± 0.61°F) than controls (mean ± SD 98.13 ± 0.59°F; F = 4.8, p = 0.03). An age (F = 14.09, p < 0.001) and time-of-day (11.4, p = 0.001) correction revealed a more robust (F = 14.02, p < 0.001) difference between depressed patients (mean ± SD 98.44 ± 0.55°F) and controls (mean ± SD 98.02 ± 0.56°F). When normalized for age and circadian differences between subjects, random, outpatient oral temperatures had a sensitivity of 63% and a specificity of 76% in identifying the depressed subjects from the controls. Independent of depression, subjects with the 5-HTTLPR deletion (short SERT allele) were warmer (mean ± SD 98.33 ± 0.65°F) than those lacking the short allele on either chromosome (mean ± SD 97.91 ± 0.69°F; F = 7.0, p = 0.01). However, the genotype did not explain the temperature differences between controls and depressed patients. Conclusion: This is the first demonstration of an increased daytime body temperature in cases with major depression. Subjects with a corrected temperature above 98.3°F were 2.6-fold more likely to be depressed. The results may strengthen the hypothesis of an inflammatory component of depression. In addition, the findings suggest a potential link between genetic differences in 5-HT transport and body temperature.

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“…Yerevanian et al 1986;Deltito et al 1991;Thalen et al 1995). No evidence was provided for the relationship between antidepressant and phaseshifting effects of bright light in non-SAD (Rao et al 1992;Yamada et al 1995;Gordijn et al 1998).…”

Section: Introductionmentioning

confidence: 75%

“…There were reports of both positive (Kripke et al 1983(Kripke et al , 1992Yamada et al 1995) and negative findings (Stinson & Thompson 1990;Mackert et al 1991;Gordijn et al 1998), as well as the reports indicating that the clinical response in non-seasonally depressed patients is modest compared to that in patients with winter depression (i.e. Yerevanian et al 1986;Deltito et al 1991;Thalen et al 1995).…”

Section: Introductionmentioning

confidence: 94%

Antidepressant effects of mono- and combined non-drug treatments for seasonal and non-seasonal depression

Putilov

Pinchasov²,

Poljakova³

2005

Biological Rhythm Research

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The involvement of chronobiological mechanisms in the antidepressant response to such non-drug treatments as bright light, physical exercise and sleep deprivation still remain to be clarified. We compare the efficacy of several treatment strategies for seasonal and non-seasonal depression and discuss possible the contribution of chronobiological and psychological mechanisms in antidepressant response. The therapeutic effects were tested at the medical academic hospital near Novosibirsk (55 degrees North) in 138 subjects, either with winter depression or with non-seasonal depression or without depression (n = 41, 64 and 33, respectively). One-week monotreatments were either 2-hour 2500 lux cool-white incandescent light from 14:00 (n = 9, 9, 9, respectively) or 1-hour physical exercise from 13:00 (n = 9, 9, 9, respectively). One-week combined treatments included a night of total sleep deprivation followed by either 2-hour bright light from 14:00 (n = 8, 12, 0, respectively) or 1-hour physical exercise either under ordinary room light from 13:00 (n = 0, 12, 0, respectively) or under bright light from 12:00 (n = 5, 11, 0, respectively). The results indicate that, in subjects left without antidepressant treatment for a week (n = 10, 11, and 15, respectively), the 21-item Hamilton Depression Rating Scale score did not change significantly. The beneficial effects of total sleep deprivation were similar in seasonal and non-seasonal depression. The seasonals exhibited better response to bright light compared to non-seasonals. After sleep deprivation the substantial further improvements were produced by either lighting or exercising. Compared to the patients exercising under ordinary room light, the patients exercising under bright light did not gain an additional benefit. In general, winter depression was well-treated with either exercise or light, while the most promising treatment for non-seasonal depression was physical exercise combined with sleep deprivation. Bright light or physical exercise administered in the middle of the day were not less favorable compared to the treatments in the morning hours, although it is unlikely that they considerably challenged patient's chronobiology. It was concluded that the placebo effect would account for a large portion of clinical response to open non-pharmacological treatments. Therapeutic hops and visibility of such treatments would explain their high antidepressant efficacy in comparison with pharmacological trials applying a double blind cross-over design. In particular, the excellent response of patients with winter depression to light therapy might be related to their tendency to attribute a high symbolic value to bright light and associate their bad mood with a dark season.

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Testing the Hypothesis of a Circadian Phase Disturbance Underlying Depressive Mood in Nonseasonal Depression

Cited by 21 publications

References 39 publications

Molecular Clock Genes in Man and Lower Animals Possible Implications for Circadian Abnormalities in Depression

Molecular Clock Genes in Man and Lower Animals Possible Implications for Circadian Abnormalities in Depression

Depressed Patients Have Higher Body Temperature: 5-HT Transporter Long Promoter Region Effects

Antidepressant effects of mono- and combined non-drug treatments for seasonal and non-seasonal depression

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