Elsevier

Psychiatry Research

Volume 16, Issue 1, September 1985, Pages 51-63
Psychiatry Research

Circadian rhythms in endogenous depression

https://doi.org/10.1016/0165-1781(85)90028-9Get rights and content

Abstract

A comprehensive study of circadian rhythms was carried out in 16 drug-free patients with endogenous depression, 10 of whom were reinvestigated after clinical remission, and 10 healthy control. No free-running periods were observed in body temperature, urinary excretion of potassium and free cortisol, or any other variable. Moreover, there was little, if any, indication of phase-advance. The circadian variation of several variables was reduced during depression, e.g., motor activity, body temperature, and (less markedly) urinary potassium, but not cortisol. The circadian worsening of mood tended to occur around the time of awakening during depression, i.e., several hours later than after remission or in normal controls. In patients with circadian variation of self-rated mood, the acrophase of this variable correlated significantly with that of urinary free cortisol. This indicates an entrainment of the disease process to the circadian rhythm of cortisol secretion, probably via circadian variations of neurotransmitters in the hypothalamus. The other circadian phenomena observed in depression can adequately be explained by masking effects (negative or positive) of psychopathological symptoms (e.g., early morning awakening) on overt circadian rhythms.

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    An earlier version of this article was presented as part of a symposium at the World Congress of Psychiatry, Vienna, July 1983. The article, in its present form, was submitted on January 18, 1984. Three articles from the same symposium were published in the August issue. The remainder appear in this and subsequent issues as part of a special section on the psychobiology of depression. The major topics addressed in the group of articles, assembled by Prof. Dr. D. Von Zerssen, are chronobiological and psychoendocrine research on depressive disorders.

    Detlev von Zerssen, Dr.med., Dipl. Psych., Professor of Psychiatry, is Head of the Psychiatric Department; Heinz Barthelmes, Dipl.-Ing., Gerhard Dirlich, Dr.phil., Dipl.-Math., and Lübbo von Lindern, Dr.rer.nat., Dipl.-Phys., are in the Department of Biostatistics; Karl M. Pirke, Dr.med., Senior Lecturer in Clinical Chemistry, is in the Department of Clinical Chemistry; Hinderk M. Emrich, Dr.med., Professor of Neurophysiology, is Head of the Department of Psychopharmacology; Peter Doerr, Dr.med.habil., and Reimer Lund, Dr.phil., Dipl.-Psych., are in the Psychiatric Department, Max-Planck-Institut für Psychiatry, Munich. Dr. Lund is now at the Psychiatric University Hospital, Munich.

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