Sleep-related chronobiological markers of affective illness.
Sleep EEG and neuroendocrine disturbances have been described in the acute phase of affective illness. The question arises as to whether these biological marker disturbances are state- or trait-related. This important issue can be addressed by evaluating changes in sleep EEG and neuroendocrine parameters from a chronobiological approach before and after antidepressant treatment. Among the circadian variables explored in affectively ill patients are REM sleep and slow wave sleep, as well as circadian secretion of plasma GH, cortisol, ACTH and prolactin. Our studies show that depressed patients mainly of the unipolar type secrete more GH and cortisol during the circadian period than control subjects do. GH hypersecretion appears mainly during wakefulness while cortisol hypersecretion is observed during the 24 h space. Temporal disorganization of hormonal secretion is also present since an advance of the quiescent period of the ACTH-cortisol rhythm as well as pre-sleep GH spikes were described in our depressed unipolar patients before treatment. After antidepressive treatment, these chronobiological anomalies tend to normalize, as state biological markers. These observations are giving support to the phase-advance hypothesis of depression.
Mendlewicz
J
J
Department of Psychiatry, University of Brussels, Erasme Hospital, Belgium.
D000324:Adrenocorticotropic Hormone / Q000097:blood; D015415:Biomarkers; D002940:Circadian Rhythm / Q000502:physiology*; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D019964:Mood Disorders / Q000097:blood / Q000503:physiopathology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012890:Sleep / Q000502:physiology*
D015415:Biomarkers; D000324:Adrenocorticotropic Hormone; D013006:Growth Hormone; D006854:Hydrocortisone