Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

A chronobiological approach to therapy for depression

https://doi.org/10.14412/2074-2711-2017-3-31-35

Full Text:

Abstract

In the modern world, the discrepancy between biological and social rhythms in the presence of the existing genetic predisposition increases a risk for the occurrence and chronicity of depression. To solve this problem, various approaches, including a chronobiological one, are applied.
Objective: to explore the relationship between chronobiological characteristics and psychopharmacotherapy in patients with depression.
Patients and methods Eighty patients with depression, among whom women (68.7%) predominated, were examined. The age of the patients was 18–75 years (47.6±15.6 years). Their chronotype was identified using the Morningness–Eveningness Questionnaire (MEQ) to determine the type of circadian rhythm. Changes in the patients' status were clinically assessed utilizing the psychometric indicators.
Results. Sleep disorders were most pronounced in recurrent depression (4.1±1.1 scores) (Montgomery–Asberg Depression Rating Scale, MADRS, item 4). The inverted pattern of daily variations was more frequently observed in patients with a first depressive episode (p<0.05).
According to MEQ scores, the investigators identified three groups of patients with morning (5%), intermediate (65%), and evening (30%) chronotypes. At the same type, the latter chronotype was clearly associated with the positive family history of affective disorders, earlier onset of depression, a larger number of experienced episodes, a higher average duration of an episode in the history, younger age, and severe condition when visiting a physician's office required additional psychopharmacotherapy. It was more effective to use antidepressants in the morning, if the patient had an evening chronotype, and in the evening, if he/she had a morning/intermediate chronotype.
Conclusion. The patients with initially different chronotypes showed differences in the premorbid, onset, and course of the disease. The account of a chronotype can be considered as one of the approaches to optimize psychopharmacotherapy.

About the Author

M. Yu. Gerasimchuk
Faculty of General Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation

11, Rossolimo St., Build. 9, Moscow 119021

Department of Psychiatry and Narcology



References

1. Chaudhury D, Liu H, Han MН. Neuronal correlates of depression. Cell Mol Life Sci. 2015;72(24):4825-48. doi: 10.1007/s00018-015-2044-6. Epub 2015 Nov 5.

2. Парфенов ВА. Постинсультная депрессия: распространенность, патогенез, диагностика и лечение. Неврология, нейропсихиатрия, психосоматика. 2012;4(4):84-8. [Parfenov VA. Poststroke depression: prevalence, pathogenesis, diagnosis, and treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(4):84-8. (In Russ.)]. doi: 10.14412/2074-2711-2012-428

3. Czeh B, Fuchs E, Wiborg O, Simon M. Animal models of major depression and their clinical implications. Prog Neuropsychopharmacol Biol Psychiatry. 2016 Jan 4;64:293-310. doi: 10.1016/j.pnpbp.2015.04.004. Epub 2015 Apr 17.

4. Wedegaertner F, Arnhold-Kerri S, Sittaro NA, et al. Depression – and anxietyrelated sick leave and the risk of permanent disability and mortality in the working population in Germany: a cohort study. BMC Public Health. 2013 Feb 17;13:145. doi: 10.1186/1471-2458-13-145.

5. Shapero BG, Weiss RB, Burke TA, et al. Kindling of Life Stress in Bipolar Disorder: Effects of Early Adversity. Behav Ther. 2017 May; 48(3):322-34. doi: 10.1016/j.beth.2016. 12.003. Epub 2016 Dec 26.

6. Тиганов АС, редактор. Психиатрия: руководство для врачей. Москва: Медицина; 2012. С. 638-677. [Tiganov AS, editor. Psikhiatriya: rukovodstvo dlya vrachei [Psychiatry: a guide for physicians]. Moscow: Meditsina; 2012. P. 638-77.]

7. Парфенов ВА, Абдулина ОВ, Замерград МВ. Дифференциальная диагностика и лечение вестибулярного головокружения. Неврология, нейропсихиатрия, психосоматика. 2010;2(2):49-54. [Parfenov VA, Abdulina OV, Zamergrad MV. Differential diagnosis and treatment of vestibular vertigo. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2010;2(2):49-54. (In Russ.)]. doi: 10.14412/2074-2711-2010-84

8. Kohyama J. Neurochemical and Neuropharmacological Aspects of Circadian Disruptions: An Introduction to Asynchronization. Curr Neuropharmacol. 2011 Jun;9(2): 330-41. doi: 10.2174/157015911795596522.

9. Pfeffer M, Korf HW, Wicht H. Synchronizing effects of melatonin on diurnal and circadian rhythms. Gen Comp Endocrinol. 2017 May 19. pii: S0016-6480(17)30172-7. doi: 10.1016/j.ygcen.2017.05.013. [Epub ahead of print].

10. Герасимчук МЮ. Персонифицированная и трансляционная психиатрия. Медицина и высокие технологии. 2017;(1):25-7. [Gerasimchuk MYu. Personalized and translational psychiatry. Meditsina i vysokie tekhnologii. 2017;(1):25-7. (In Russ.)].

11. Au J, Reece J. The relationship between chronotype and depressive symptoms: A meta-analysis. J Affect Disord. 2017 Apr 26; 218:93-104. doi: 10.1016/j.jad.2017.04.021. Epub 2017 Apr 26.

12. Horne JA, Ostberg O. A self-assessment questionnaire to determine morningnesseveningness in human circadian rhythms. Int J Chronobiol. 1976;4(2):97-110.

13. Герасимчук МЮ. Депрессия: перспективы дифференцированной психофармакотерапии. Архив внутренней медицины. 2016;6(4):8-13. [Gerasimchuk MYu. Depression: perspectives of differentiated psychopharmacotherapy. Arkhiv vnutrennei meditsiny. 2016;6(4):8-13. (In Russ.)]. doi:10.20514/2226-6704-2016-6-4-8-13

14. Pigeon WR, Bishop TM, Krueger KM. Insomnia as a Precipitating Factor in New Onset Mental Illness: a Systematic Review of Recent Findings. Curr Psychiatry Rep. 2017 Aug; 19(8):44. doi: 10.1007/s11920-017-0802-x.

15. von Schantz M, Taporoski TP, Horimoto AR, et al. Distribution and heritability of diurnal preference (chronotype)in a rural Brazilian family-based cohort, the Baependi study. Sci Rep. 2015 Mar 18;5: 9214. doi: 10.1038/srep09214.

16. Furusawa M, Okubo Y, Kuroda R, et al. Relationship between morningness-eveningness typology and cumulative fatigue or depressionamong Japanese male workers. Ind Health. 2015; 53(4):361-7. doi: 10.2486/indhealth.2013-0068. Epub 2015 Jun 6.

17. Bielen J, Melada A, Markeli? I. Depression and circadian typology. Psychiatr Danub. 2015 Jun;27(2):190-2.

18. Rahafar A, Castellana I, Randler C, Antunez JM. Conscientiousness but not agreeableness mediates females' tendency toward being a morning person. Scand J Psychol. 2017 Jun; 58(3):249-253. doi: 10.1111/sjop.12362.


For citation:


Gerasimchuk M.Y. A chronobiological approach to therapy for depression. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(3):31-35. (In Russ.) https://doi.org/10.14412/2074-2711-2017-3-31-35

Views: 201


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)