Chronobiology and Mood Disorders

Abstract

Living organizms show cyclic rhythmicity in a variety of physiological, hormonal, behavioral, and psychological processes. Sleep-wake cycles, body temperature, hormone levels, mood and cognition display a circadian rhythm in humans. Delays, advances or desynchronizations of circadian rhythm are known to be strongly associated with mental illness especially mood disorders such as bipolar disorder, major depression and seasonal affective disorder. Furthermore, some of the mood stabilizers, sleep deprivation and light treatment are employed to treat mood disorders by shifting circadian rhythm. This paper reviews the relationship between mood disorders and circadian rhythm, and describes treatment options by altering circadian rhythm.

Keywords

• chronobiology, biological rhythm, mood disorders, sleep

Kronobiyoloji ve Duygudurum Bozuklukları

Öz

Canlı organizmalarda biyolojik, fizyolojik, hormonal, davranışsal ve psikolojik yönü olan pek çok olay belirli bir ritme uygun şekilde oluşur. İnsanlarda uyku-uyanıklık döngüsü, vücut sıcaklığı, hormon düzeyleri, duygulanım ve bazı bilişsel işlevler sirkadyen ritim adı verilen günlük bir ritme sahiptirler. Sirkadyen ritimde meydana gelen ilerleme, gecikme veya bozulmaların psikiyatrik hastalıklarla ve özellikle de bipolar depresyon, major depresyon ve mevsimsel affektif bozukluklar gibi duygudurum bozuklukları ile güçlü bir bağlantısı vardır. Bazı duygudurum düzenleyicileri ile uyku yoksunluğu ve ışık tedavisi gibi uygulamalar etkilerini sirkadyen sistemde değişiklik yaparak göstermektedirler. Bu derlemede duygudurum bozuklukları ve sirkadyen ritim ilişkisi gözden geçirilerek sirkadyen ritim değişikliği yoluyla yapılan tedavi seçenekleri tanımlanmıştır.

Anahtar Kelimeler

• kronobiyoloji, biyolojik ritim, duygudurum bozukluğu, uyku

References

1. Schulz P. Biological clocks and the practice of psychiatry. Dialogues Clin Neurosci 2007; 9:237-255.
2. Lemmer B. Discoveries of rhythms in human biological functions: A historical review. Chronobiol Int 2009; 26:1019-1068.
3. Reinberg A, Ashkenazi I. Concepts in human biological rhythms. Dialogues Clin Neurosci 2003; 5:327-342.
4. Çalıyurt O. Duygudurum bozuklukları ve biyolojik ritm. Duygudurum Dizisi 2001; 5:209-214.
5. Macher JP. Chronobiology in psychiatry. Dialogues Clin Neurosci 2007; 9:229.
6. Wirz-Justice A. Biological rhythm disturbances in mood disorders. Int Clin Psychopharmacol 2006; 21(Suppl 1):11-15.
7. Bjorvatn B, Pallesen S. A practical approach to circadian rhythm sleep disorders. Sleep Med Rev 2009;13:47–60.
8. Schulz P, Steimer T. Neurobiology of circadian systems. CNS Drugs 2009; 23(Suppl 2):3-13.

9. Mistlberger RE, Rusak B. Circadian rhythms in mammals: Formal properties and environmental ınfluences. In Principles and Practice of Sleep Medicine, 4th ed. (Eds MH Kryger, T Roth, WC Dement):321-335. Philadelphia, WB Saunders, 2005.
10. Cermakian N, Boivin DB. A molecular perspective of human circadian rhythm disorders. Brain Res Brain Res Rev 2003; 42:204-220.
11. Schulz P, Steimer T. Neurobiology of circadian rhythms. CNS Drugs 2009; 23:3-13.
12. Monteleone P, Martiadis V, Maj M. Circadian rhythms and treatment implications in depression. Prog Neuropsychopharmacol Biol Psychiatry 2010; doi:10.1016/ j.pnpbp.2010.07.028.
13. Shochat T, Luboshitzky R, Lavie P. Nocturnal melatonin onset is phase locked to the primary sleep gate. Am J Physiol 1997; 273:364-370.
14. Srinivasan V, Pandi-Perumal SR, Trakht I, Spence DW, Hardeland R, Poeggeler B et al. Pathophysiology of depression: role of sleep and the melatonergic system. Psychiatry Res 2009; 165:201-214.
15. Szymusiak R, McGinty D. Hypothalamic regulation of sleep and arousal. Ann N Y Acad Sci 2008; 1129:275-286.
16. Grandin LD, Alloy LB, Abramson LY. The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation. Clin Psychol Rev 2006; 26:679-694.
17. Emilien G, Maloteaux JM. Circadian system and sleep anomaly in depression Ir J Psych Med 1999; 16:18-23.
18. Wirz-Justice A. Biological rhythms and depression: treatment opportunities. WPA Bulletin on Depression 2008; 12:5-8.
19. Harvey AG. Sleep and circadian functioning: Critical mechanisms in the mood disorders? Annu Rev Clin Psychol 2011; 7:1-23.
20. Perlis ML, Smith LJ, Lyness JM, Matteson SR, Pigeon WR, Jungquist CR et al. Insomnia as a risk factor for onset of depression in the elderly. Behav Sleep Med 2006; 4:104-113.
21. Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry 2005; 66:1254-1269.
22. Salvatore P, Ghidini S, Zita G, De Panfilis C, Lambertino S, Maggini C et al. Circadian activity rhythm abnormalities in ill and recovered bipolar I disorder patients. Bipolar Disord 2008; 10:256-265.
23. Morris DW, Rush AJ, Jain S, Fava M, Wisniewski SR, Balasubramani GK et al. Diurnal mood variation in outpatients with major depressive disorder: implications for DSM-V from an analysis of the Sequenced Treatment Alternatives to Relieve Depression Study data. J Clin Psychiatry 2007; 68:1339-1347.
24. McClung CA. Circadian genes, rhythms and the biology of mood disorders. Pharmacol Ther 2007; 114:222-2 32.
25. Borbely AA. A two process model of sleep regulation. Hum Neurobiol 1982; 1:195
26. Wirz-Justice A. Chronobiology and psychiatry. Sleep Med Rev 2007; 11:423-427.
27. Lack LC, Wright HR. Chronobiology of sleep in humans. Cell Mol Life Sci 2007;64:1205-1215.
28. Czeisler CA, Buxton OM, Khalsa SBS. The human circadian timing system and sleep-wake regulation. In Principles and Practice of Sleep Medicine, 4th ed. (Eds MH Kryger, T Roth, WC Dement):375-395. Philadelphia, WB Saunders, 2005.
29. Borbely AA, Peter A. Sleep Homeostazis and models of sleep regulation. In Principles and Practice of Sleep Medicine, 4th ed. (Eds MH Kryger, T Roth, WC Dement):395-405. Philadelphia, WB Saunders, 2005.
30. Van Dongen HPA, Dinges DF. Circadian rhythms in sleepiness, alertness, and performance. In Principles and Practice of Sleep Medicine, 4th ed. (Eds MH Kryger, T Roth, WC Dement):431-444. Philadelphia, WB Saunders, 2005.
31. Chellappa SL, Schroder C, Cajochen C. Chronobiology, excessive daytime sleepiness and depression: Is there a link? Sleep Med 2009; 10:505-514.
32. Wirz-Justice A, Van den Hoofdakker RH. Sleep deprivation in depression: what do we know, where do we go? Biol Psychiatry 1999; 46:445-453.
33. Wehr TA, Wirz-Justice A. Circadian rhythm mechanisms in affective illness and in antidepressant drug action. Pharmacopsychiatry 1982; 15:31-39.
34. Jones CR, Campbell SS, Zone SE, Cooper F, DeSano A, Murphy PJ et al. Familial advanced sleep-phase syndrome: a short-period circadian rhythm variant in humans. Nat Med 1999; 5:1062-1065.
35. Srinivasan V, Smits M, Spence W, Lowe AD, Kayumov L, Pandi-Perumal SR et al. Melatonin in mood disorders. World J Biol Psychiatry 2006; 7:138-151.
36. Van Cauter E, Leproult R, Kupfer DJ. Effects of gender and age on the levels and rhythmicity of plasma cortisol. J Clin Endocrinol Metab 1996; 81:2468-2473.
37. Hajak G, Landgrebe M. Time and depression:when the internal clock does not work. Medicographia 2010; 32:146-151.
38. Wehr TA, Wirz-Justice A. Internal coincidence model for sleep deprivation and depression. In Sleep 1980 (Ed. WP Koella):26-33. Basel, Switzerland, Karger, 1981.
39. Benedetti F, Barbini B, Campori E, Fulgosi MC, Pontiggia A, Colombo C. Sleep phase advance and lithium to sustain the antidepressant effect if total sleep deprivation in bipolar depression: New findings supporting the internal coincidence model? J Psychiatric Res 2001; 35:323-329.
40. Ehlers CL, Frank E, Kupfer DJ. Social zeitgebers and biological rhythms. Arch Gen Psychiatry 1988; 45:948-952.
41. Malkoff-Schwartz S, Frank E, Anderson BP, Hlastala SA, Luther JF, Sherril JT, et al. Social rhythm disruption and stressful life events in the onset of bipolar and unipolar episodes. Psychol Med 2000; 30:1005-1016.
42. Adan A, Lachica J, Caci H, Natale V. Circadian typology and temperament and character personality dimensions. Chronobiol Int 2010; 27:181-193.
43. Emens JS, Yuhas K, Rough J, Kochar N, Peters D, Lewy AJ. Phase angle of entrainment in morning and evening types under naturalistic conditions. Chronobiol Int 2009; 26:474-493.
44. Taillard J, Philip P, Bioulac B. Morningness/eveningness and the need for sleep. J Sleep Res 1999; 8:291-295.
45. Selvi Y, Aydin A, Boysan M, Atli A, Agargun MY, Besiroglu L. Associations between chronotype, sleep quality, suicidality, and depressive symptoms in patients with major depression and healthy controls. Chronobiol Int 2010; 27:1813-1828.
46. Selvi Y, Aydin A, Atli A, Boysan M, Selvi F, Besiroglu L. Chronotype differences in suicidal behavior and impulsivity among suicide attempters. Chronobiol Int 2011; 28:170-175.
47. Hasler BP, Allen JJ, Sbarra DA, Bootzin RR, Bernert RA. Morningness-eveningness and depression: Preliminary evidence for the role of the behavioral activation system and positive affect. Psychiatr Res 2010; 176:166-173.
48. Selvi Y, Smolensky MH, Boysan M, Aydin A, Besiroglu L, Atli A, et al Role of patient chronotype on circadian pattern of myocardial infarction: A pilot study. Chronobiol Int 2011; doi:10.3109/07420528.2011.559605.
49. Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y et al. Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Arch Gen Psychiatry 1984; 41:72-80.
50. Boivin DB. Influence of sleep-wake and circadian rhythm disturbances in psychiatric disorders. J Psychiatry Neurosci 2000; 25:446-458.
51. McClung CA. Circadian genes, rhythms and the biology of mood disorders. Pharmacol Ther 2007; 114:222-232.
52. Harvey AG. Sleep and circadian rhythms in bipolar disorder: seeking synchrony, harmony, and regulation. Am J Psychiatry 2008; 165:820-829.
53. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.
54. Wirz-Justice A, Benedetti F, Terman M. Chronotherapeutics for Affective Disorders: A Clinician’s Manual for Light and Wake Therapy. Basel, Switzerland, Karger, 2009.
55. Golden RN, Gaynes BN, Ekstrom RD, Hamer RM, Jacobsen FM, Suppes T et al. The efficacy of light therapy in the treatment of mood disorders: a review and meta- analysis of the evidence. Am J Psychiatry 2005; 162:656-662.
56. Pandi-Perumal SR, Srinivasan V, Maestroni GJ, Cardinali DP, Poeggeler B, Hardeland R. Melatonin: Nature's most versatile biological signal? FEBS J 2006; 273:2813-2838.
57. Wehr T A, Duncan WC, Sher L, Aeschbach D, Schwartz P J, Turner EH. A circadian signal of change of season in patients with seasonal affective disorder. Arch Gen Psychiatry 2001; 58:1108−1114.
58. Wirz Justice A. Biological rhythms in mood disorders. In Psychopharmacology: The Third Generation of Progress (Eds FE Bloom, DJ Kupfer):999-1017. New York, Raven Press, 1995.
59. Benedetti F, Serretti A, Colombo C, Campori E, Barbini B, di Bella D et al. Influence of a functional polymorphism within the promoter of the serotonin transporter gene on the effects of total sleep deprivation in bipolar depression. Am J Psychiatry 1999; 156:1450-1452.
60. Ebert D, Albert R, Hammoressant G, Strasser B, May A, Merz A. Eye-blink rates and depression: is the antidepressant effect of sleep deprivation mediated by the dopamine system? Neuropsychopharmacology 1996; 15:332-339.
61. Racagni G, Riva MA, Popoli M. The interaction between the internal clock and antidepressant efficacy. Int Clin Psychopharmacol 2007; 22(Suppl 2):9-14.
62. Wirz-Justice A. Chronobiology and mood disorders. Dialogues Clin Neurosci 2003; 5:315-326.
63. Quiroz JA, Gould TD, Manji HK. Molecular effects of lithium. Mol Interv 2004; 4:259-272.
64. Yin L, Wang J, Klein PS, Lazar MA. Nuclear receptor Reverbalpha is a critical lithium-sensitive component of the circadian clock. Science 2006; 311:1002-1005.
65. Sprouse J, Braselton J, Reynolds L. Fluoxetine modulates the circadian biological clock via phase advances of suprachiasmatic nucleus neuronal firing. Biol Psychiatry 2006; 60:896-899.
66. Thase ME. Bipolar depression: issues in diagnosis and treatment. Harv Rev Psychiatry 2005; 13: 257-271.
67. Lemoine P, Guilleminault C, Alvarez, E. Improvement in subjective sleep in major depressive disorder with a novel antidepressant, agomelatine: randomized, double- blind comparison with venlafaxine. J Clin Psychiatry 2007;68:1723-1732.
68. Boyce P, Barribal E. Circadian rhythms and depression. Aust Fam Physician 2010; 39:307-310.
69. Giedke H, Schwarzler F. Therapeutic use of sleep deprivation in depression. Sleep Med Rev 2002; 6:361-377.
70. Çalıyurt O, Edis EÇ, Altıay G. Akut tam uyku yoksunluğunun enerji metabolizması üzerine etkileri. Nöropsikiyatri Arşivi 2011; 48:17-21.
71. Hemmeter UM, Hemmeter-Spernal J, Krieg JC. Sleep deprivation in depression. Expert Rev Neurother 2010; 10:1101-1115.
72. Benedetti F, Barbini B, Fulgosi MC. Combined total sleep deprivation and light therapy in the treatment of drug-resistant bipolar depression: acute response and long-term remission rates. J Clin Psychiatry 2005; 66:1535-1540.
73. Caliyurt O, Guducu F. Partial sleep deprivation therapy combined with sertraline induces more rapid improvements in quality of life items in major depressive disorder. J Affect Disord 2005; 88:75-78.
74. Bouhuys AL. Towards a model of mood responses to sleep deprivation in depressed patients. Biol Psychiatry 1991; 29:600-612.
75. Selvi Y, Gulec M, Agargun MY, Besiroglu L. Mood changes after sleep deprivation in morningness–eveningness chronotypes in healthy individuals. J Sleep Res 2007;16: 241-244.
76. Svestka J. Sleep deprivation therapy. Neuro Endocrinol Lett 2008; 29(Suppl 1):65
77. Monteleone P, Maj M. The circadian basis of mood disorders: recent developments and treatment implications. Eur Neuropsychopharmacol 2008;18:701-711.
78. Endo T, Schwierin B, Borbely AA, Tobler I. Selective and total sleep deprivation: Effect on the sleep EEG in the rat. Psychiatry Res 1997; 66:97-110.
79. Giedke H, Schwarzler F. Therapeutic use of sleep deprivation in depression. Sleep Med Rev 2002; 6:361-377.
80. Harvey AG. Sleep and circadian rhythms in bipolar disorder: Seeking synchrony, harmony, and regulation. Am J Psychiatry 2008; 165:820-829.
81. Prasko J. Bright light therapy. Neuro Endocrinol Lett 2008; 29(Suppl 1):33-64.
82. Roecklein KA, Rohan KJ, Postolache TT. Is seasonal affective disorder a bipolar variant? Curr Psychiatry 2010; 9:42-54.
83. Lam RW, Tam EM. A Clinician’s Guide to Using Light Therapy. New York, Cambridge University Press, 2009.
84. Partonen T, Magnusson A. Seasonal Affective Disorder: Practice and Research. New York, Oxford University Press, 2009.
85. Lee TM, Blashko CA, Janzen HL, Paterson JG, Chan CC. Pathophysiological mechanism of seasonal affective disorder. J Affect Disord 1997; 46:25-38.
86. Terman M, Terman JS. Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects. CNS Spectr 2005; 10:647-663.
87. Terman M, Terman JS. Light treatment. In Principles and Practice of Sleep Medicine, 4th ed (Eds MH Kryger, T Roth, WC Dement):1424-1443. Philadelphia, WB Saunders, 2005.
88. Dağdeviren N, Oral ET, Dedeoğlu S. Bipolar affektif bozuklukta mevsimsellik. Dü- şünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi 1998; 11:53-55.
89. Noyan MA, Karababa AO, Veznedaroğlu B, Elbi H, Korukoğlu S. İzmir’de yarı-kırsal bir bölgede mevsimsel duygudurum bozukluğunun yaygınlığı. Anadolu Psikiyatri Dergisi 2001; 2:169-174.
90. Güdücü F, Caliyurt O, Vardar E, Tuğlu C, Abay E. Majör Depresyonda sertralin ile birlikte uygulanan uyku yoksunluğu ve ışık tedavisinin etkinliğinin sertralin tedavisi ile karşılaştırılması. Turk Psikiyatri Derg 2005; 16:245-251.
91. Hızlı FG, Ağargün MY. Gecikmiş uyku fazı tipi uyku bozukluğu ve kronoterapi. Turk Psikiyatri Derg 2009; 20:183-187.
92. Gorgulu Y, Caliyurt O. Rapid antidepressant effects of sleep deprivation therapy correlates with serum BDNF changes in major depression. Brain Res Bull 2009; 80:158-162.
93. Çalıyurt O, Güdücü F. Depresyonda uyku yoksunluğu tedavisi uygulamaları. Klinik Psikiyatri Dergisi 2004; 7:120-126.
94. Selvi Y, Özdemir PG, Özdemir O, Aydın A, Beşiroğlu L. Sağlık çalışanlarında vardi- yalı çalışma sisteminin sebep olduğu genel ruhsal belirtiler ve yaşam kalitesi üzerine etkisi. Düşünen Adam: Psikiyatri ve Nörolojik Bilimler Dergisi 2010; 23:238-243.
95. Selvi Y, Ozkol H, Tuluce Y, Besiroglu L, Ozdemir PG. Chronotypes and oxidative stress: Is there an association? Biol Rhythm Res 2011; doi: 10.1080/09291016.2010.548927.