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Huo Z, Ge F, Li C, Cheng H, Lu Y, Wang R, Wen Y, Yue K, Pan Z, Peng H, Wu X, Liang H, He J, Liang W. Genetically predicted insomnia and lung cancer risk: a Mendelian randomization study. Sleep Med 2021; 87:183-190. [PMID: 34627121 DOI: 10.1016/j.sleep.2021.06.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The relationship between insomnia and lung cancer is scanty. The Mendelian randomization approach provides the rationale for evaluating the potential causality between genetically-predicted insomnia and lung cancer risk. METHODS We extracted 148 insomnia-related single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) from published genome-wide association studies (GWASs). Summary data of individual-level genetic information of participants were obtained from the International Lung Cancer Consortium (ILCCO) (29,266 cases and 56,450 controls). MR analyses were performed using the inverse-variance-weighted approach, MR pleiotropy residual sum and outlier (MR-PRESSO) test, weighted median estimator, and MR-Egger regression. Sensitivity analyses were further performed using Egger intercept analysis, leave-one-out analysis, MR-PRESSO global test, and Cochran's Q test to verify the robustness of our findings. RESULTS The results of the MR analysis indicated an increased risk of lung cancer in insomnia patients (OR = 1.1671; 95% CI 1.0754-1.2666, p = 0.0002). The subgroup analyses showed increased risks of lung adenocarcinoma (OR = 1.1878; 95% CI 1.0594-1.3317, p = 0.0032) and squamous cell lung cancer (OR = 1.1595; 95% CI 1.0248-1.3119, p = 0.0188). CONCLUSION Our study indicated that insomnia is a causal risk factor in the development of lung cancer. Due to the lack of evidence on both the epidemiology and the mechanism level, more studies are needed to better elucidate the results of the study.
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Affiliation(s)
- Zhenyu Huo
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Nanshan School, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Fan Ge
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; First Clinical School, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Caichen Li
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Heting Cheng
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Department of Psychology, School of Health Management, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Yi Lu
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Nanshan School, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Runchen Wang
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Nanshan School, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Yaokai Wen
- School of Medicine, Tongji University, Shanghai, China; Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Keqi Yue
- Department of Biological Science, The Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Zixuan Pan
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Haoxin Peng
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Nanshan School, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Xiangrong Wu
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China; Nanshan School, Guangzhou Medical University, Xinzao Road, Panyu District, Guangzhou, 511436, China
| | - Hengrui Liang
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Jianxing He
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
| | - Wenhua Liang
- Department of Thoracic Surgery and Oncology, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
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Kataoka H, Saeki K, Kurumatani N, Sugie K, Obayashi K. Melatonin secretion in patients with Parkinson's disease receiving different-dose levodopa therapy. Sleep Med 2020; 75:309-314. [PMID: 32950012 DOI: 10.1016/j.sleep.2020.07.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/05/2020] [Accepted: 07/22/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Melatonin is involved in the regulation of sleep and circadian biological rhythmicity; decreased melatonin secretion has been associated with circadian disruptions. Previous studies evaluating melatonin levels between patients with Parkinson's disease (PD) and controls without PD have found conflicting results; however, large-scale studies have not been performed. Our aim is to compare endogenous melatonin levels between patients with Parkinson's disease (PD) and non-PD older adults. METHODS In this cross-sectional study on 201 outpatients with PD and 380 community-dwelling older Japanese adults (controls), urinary 6-sulfatoxymelatonin excretion was measured to estimate endogenous melatonin levels. RESULTS Urinary 6-sulfatoxymelatonin excretion (UME) did not significantly differ overall between PD patients and non-PD controls, even after adjusting for age, gender, medications, sleep habits, and seasons. Among PD patients, a clear and robust dose-response association was found between levodopa equivalent dose and UME, independent of potential confounding factors, including Parkinson's disease severity. Compared with the lowest levodopa equivalent dose quartile group (mean levodopa equivalent dose, 132 mg/day), the highest group (mean levodopa equivalent dose, 973 mg/day) exhibited a 68% increase in UME (17.8 vs. 30.0 ng/mg cre, respectively). In addition, compared with the non-PD controls, PD patients receiving a lower levodopa equivalent dose displayed decreased UME and those receiving higher levodopa equivalent dose displayed increased UME. CONCLUSION Our study suggests that melatonin levels in PD patients receiving average levodopa doses are comparable with those in older adults, even after considering confounding factors. This association was modulated by daily levodopa dose in PD patients.
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Affiliation(s)
- Hiroshi Kataoka
- Department of Neurology, Nara Medical University School of Medicine, Nara, Japan.
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Norio Kurumatani
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University School of Medicine, Nara, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
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Hoyos CM, Gordon C, Terpening Z, Norrie L, Lewis SJG, Hickie IB, Naismith SL. Circadian rhythm and sleep alterations in older people with lifetime depression: a case-control study. BMC Psychiatry 2020; 20:192. [PMID: 32349697 PMCID: PMC7191686 DOI: 10.1186/s12888-020-02606-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 04/16/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Depression is common in older people and is associated with underlying brain change increasing the risk of dementia. Sleep disturbance is frequently reported by those with lifetime depression, however whether circadian misalignment also exists is unclear. We aimed to examine circadian rhythms and sleep associations in older patients with and without lifetime depression. METHODS Thirty-four older people meeting DSM-IV criteria for lifetime major depression (mean age = 63.9 years), and 30 healthy controls (mean age = 65.7 years) were recruited. Participants underwent 2-weeks of actigraphy followed by a 3-night protocol including dim light melatonin onset (DLMO) assessment and overnight polysomnography (PSG) for sleep architecture. DLMO and phase angle of entrainment were computed. RESULTS Compared to controls, participants with depression had a significantly longer phase angle of entrainment (6.82 h ± 1.45 vs. 5.87 h ± 1.60, p = 0.02, Cohens-d = 0.62). A small to moderate yet non-significant difference in DLMO times, with earlier DLMO (34 ± 27 min) observed in depression (20:36 ± 1:48 vs. 21:10 ± 1:48, p = 0.22, Cohens-d = 0.32). Individuals with depression had longer sleep latency and latency to rapid eye movement sleep than controls (all p < 0.05). CONCLUSION Circadian advancement and alterations to the timing of sleep and REM onset are evident in older people with lifetime major depression, despite having only mild residual symptoms. Further research examining the prognostic significance of these changes is warranted as well as chronotherapeutic treatment studies.
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Affiliation(s)
- Camilla M. Hoyos
- grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Healthy Brain Ageing Program, Sydney, NSW Australia ,grid.417229.b0000 0000 8945 8472CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Christopher Gordon
- grid.417229.b0000 0000 8945 8472CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, NSW Australia
| | - Zoe Terpening
- grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW Australia ,grid.1005.40000 0004 4902 0432Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Louisa Norrie
- grid.437825.f0000 0000 9119 2677St Vincent’s Hospital Older People’s Mental Health Service, Darlinghurst, NSW Australia
| | - Simon J. G. Lewis
- grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW Australia
| | - Ian B. Hickie
- grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW Australia
| | - Sharon L. Naismith
- grid.1013.30000 0004 1936 834XThe University of Sydney, Faculty of Science, School of Psychology, Sydney, NSW Australia ,grid.1013.30000 0004 1936 834XThe University of Sydney, Brain and Mind Centre, Healthy Brain Ageing Program, Sydney, NSW Australia
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Obayashi K, Saeki K, Maegawa T, Iwamoto J, Sakai T, Otaki N, Kataoka H, Kurumatani N. Melatonin Secretion and Muscle Strength in Elderly Individuals: A Cross-Sectional Study of the HEIJO-KYO Cohort. J Gerontol A Biol Sci Med Sci 2016; 71:1235-40. [DOI: 10.1093/gerona/glw030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/03/2016] [Indexed: 12/25/2022] Open
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Obayashi K, Saeki K, Iwamoto J, Tone N, Tanaka K, Kataoka H, Morikawa M, Kurumatani N. Physiological Levels of Melatonin Relate to Cognitive Function and Depressive Symptoms: The HEIJO-KYO Cohort. J Clin Endocrinol Metab 2015; 100:3090-6. [PMID: 26052727 DOI: 10.1210/jc.2015-1859] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
CONTEXT In contrast with randomized controlled trials, observational studies have suggested that physiological levels of melatonin are reduced in patients with dementia or depression, but the relationship has not been evaluated in large populations. OBJECTIVE The objective was to determine the relationships between physiological levels of melatonin and cognitive function and depressive symptoms. DESIGN AND PARTICIPANTS A cohort of 1105 community-dwelling elderly individuals was enrolled in this cross-sectional study (mean age, 71.8 ± 7.1 y). MEASURES Urinary 6-sulfatoxymelatonin excretion (UME) and Mini-Mental State Examination (MMSE; n = 935) and Geriatric Depression Scale (GDS; n = 1097) scores were measured as indices of physiological melatonin levels, cognitive function, and depressive symptoms, respectively. RESULTS With increases in UME quartiles, the prevalence of cognitive impairment (MMSE score ≤ 26) and depressed mood (GDS score ≥ 6) significantly decreased (P for trend = .003 and .012, respectively). In multivariate logistic regression models, after adjusting for confounders such as age, gender, socioeconomic status, physical activity, and sleep/wake cycles, higher UME levels were significantly associated with lower odds ratios (ORs) for cognitive impairment and depressed mood (ORs: Q1 = 1.00; Q2 = 0.88 and 0.76; Q3 = 0.66 and 0.85; Q4 = 0.67 and 0.53; P for trend = .023 and .033, respectively). In addition, the highest UME group showed a significantly lower OR for depressed mood than the lowest UME group (Q4 vs Q1: OR, 0.53; 95% confidence interval, 0.32-0.89; P = .033). UME levels above the median value were significantly associated with a lower OR for cognitive impairment, even after further adjustment for depressive symptoms (OR = 0.74; 95% confidence interval, 0.55-0.99; P = .043). CONCLUSIONS Significant associations of higher physiological melatonin levels with lower prevalence of cognitive impairment and depressed mood were revealed in a large general elderly population. The association between physiological melatonin levels and cognitive function was independent of depressive symptoms.
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Affiliation(s)
- Kenji Obayashi
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Keigo Saeki
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Junko Iwamoto
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Nobuhiro Tone
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Kunihiko Tanaka
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Hiroshi Kataoka
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Masayuki Morikawa
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology (K.O., K.S., N.K.), Center for Academic Industrial and Governmental Relations (N.T.), Department of Neurology (H.K.), and Department of Psychiatry (M.M.), Nara Medical University School of Medicine, Nara 634-8521, Japan; Department of Nursing (J.I.), Tenri Health Care University, Nara 632-0018, Japan; Osaka City University Graduate School of Medicine (K.T.), Osaka 545-8585, Japan; and Mie Prefectural Mental Care Center (M.M.), Mie 514-0818, Japan
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Luojus MK, Lehto SM, Tolmunen T, Erkkilä AT, Kauhanen J. Sleep duration and incidence of lung cancer in ageing men. BMC Public Health 2014; 14:295. [PMID: 24684747 PMCID: PMC4229981 DOI: 10.1186/1471-2458-14-295] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 03/27/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Previous studies have suggested an association between sleep duration and cancer. However, the information on sleep duration regard to risk of lung cancer is scanty. METHODS Analysed data comprised prospective population-based cohort of 2586 men (aged 42-60 years) from Eastern Finland. Baseline survey and clinical examinations took place 1984-1989, and diagnosed lung cancers were obtained until the end of 2011 through linkage with the Finnish Cancer Registry. Self-reported sleep was categorized as ≤6.5 h, 7-7.5 h, and ≥8 h. Subjects with prior history of cancer or psychotropic medication (hypnotics or sedatives) were excluded from the analyses. Cox proportional hazards models with adjustments for possible confounders were used to examine the association. RESULTS Significant association between sleep duration and increased lung cancer risk was observed after adjustments for age, examination years, cumulative smoking history, family cancer history and Human Population Laboratory Depression scale scores (HR 2.12, 95% CI 1.17-3.85 for ≤6.5 h sleep, and HR 1.88, 95% CI 1.09-3.22 for ≥8 h sleep). Associations were even stronger among current smokers (HR 2.23, 95% CI 1.14-4.34 for ≤6.5 h sleep, and HR 2.09, 95% CI 1.14-3.81 for ≥8 h sleep). After further adjustments for alcohol consumption, physical activity, body mass index, marital status, education years, night work, employment status, asthma and chronic bronchitis, the association remained significant both in the whole study population and among smokers. When cumulative smoking history was replaced by current smoking in the adjustments, the increased risk was limited to those who slept<6.5 h. CONCLUSIONS Sleep duration of less than 7-7.5 hours or more than 7-7.5 hours associates with increased lung cancer risk. The physiological factors underlying the association are complex, and they may relate to melatonin excretion patterns, low-grade inflammation in cancer development process or disruptions in circadian rhythmicity.
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Affiliation(s)
- Maria K Luojus
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 162770211 Kuopio, Finland
| | - Soili M Lehto
- Department of Psychiatry, Kuopio University Hospital, P.O. Box 10070029 KYS Kuopio, Finland
- University of Eastern Finland, P.O. Box 162770211 Kuopio, Finland
| | - Tommi Tolmunen
- Department of Psychiatry, Kuopio University Hospital, P.O. Box 10070029 KYS Kuopio, Finland
- University of Eastern Finland, P.O. Box 162770211 Kuopio, Finland
| | - Arja T Erkkilä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 162770211 Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 162770211 Kuopio, Finland
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Toffol E, Kalleinen N, Haukka J, Vakkuri O, Partonen T, Polo-Kantola P. The effect of hormone therapy on serum melatonin concentrations in premenopausal and postmenopausal women: a randomized, double-blind, placebo-controlled study. Maturitas 2014; 77:361-9. [PMID: 24602553 DOI: 10.1016/j.maturitas.2014.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 01/17/2014] [Accepted: 01/27/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Melatonin levels decrease physiologically with age, and possibly with the transition to menopause. The plausible influence of hormone therapy (HT) on melatonin is poorly understood. The aim of this randomized, placebo-controlled, double-blind trial was to investigate the effect of HT administration on serum melatonin concentrations in late premenopausal and postmenopausal women. STUDY DESIGN Analyses were carried out among 17 late premenopausal and 18 postmenopausal healthy women who participated in a prospective HT study in Finland. Serum melatonin was sampled at 20-min (21:00-24:00 h; 06:00-09:00 h) and 1-h (24:00-06:00 h) intervals at baseline and after 6 months with HT or placebo. MAIN OUTCOME MEASURES Melatonin levels and secretion profile after 6 months of HT compared to placebo. RESULTS Mean melatonin levels, mean melatonin exposure level (area under curve, AUC) and mean duration of melatonin secretion did not differ after 6 months with HT vs. placebo, irrespectively of the reproductive state. However, in postmenopausal women the melatonin peak time (acrophase) was delayed by 2.4h (2 h 21 min) on average after 6 months with HT vs. placebo (p<0.05). No interaction between time and group was detected when melatonin level was modelled before or after treatment. CONCLUSIONS Administration of HT to postmenopausal women alters melatonin peak time, but not melatonin levels. Further research on larger clinical samples is needed to better understand the effects of HT on melatonin profile.
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Affiliation(s)
- Elena Toffol
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, Helsinki, Finland.
| | - Nea Kalleinen
- Sleep Research Unit, Department of Physiology, University of Turku, Lemminkäisenkatu 14-18A, 5th Floor, Turku, Finland; Heart Center, Turku University Hospital and University of Turku, PL 52, Turku, Finland
| | - Jari Haukka
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, Helsinki, Finland; Department of Public Health, Hjelt Institute, University of Helsinki, Mannerheimintie 172, Helsinki, Finland
| | - Olli Vakkuri
- Department of Physiology, University of Oulu, Aapistie 7, Oulu, Finland
| | - Timo Partonen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Mannerheimintie 170, Helsinki, Finland
| | - Päivi Polo-Kantola
- Sleep Research Unit, Department of Physiology, University of Turku, Lemminkäisenkatu 14-18A, 5th Floor, Turku, Finland; Department of Obstetrics and Gynaecology, Turku University Central Hospital and University of Turku, PL 52, Turku, Finland
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De Berardis D, Marini S, Fornaro M, Srinivasan V, Iasevoli F, Tomasetti C, Valchera A, Perna G, Quera-Salva MA, Martinotti G, di Giannantonio M. The melatonergic system in mood and anxiety disorders and the role of agomelatine: implications for clinical practice. Int J Mol Sci 2013; 14:12458-83. [PMID: 23765220 PMCID: PMC3709794 DOI: 10.3390/ijms140612458] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 05/22/2013] [Accepted: 05/22/2013] [Indexed: 02/07/2023] Open
Abstract
Melatonin exerts its actions through membrane MT1/MT2 melatonin receptors, which belong to the super family of G-protein-coupled receptors consisting of the typical seven transmembrane domains. MT1 and MT2 receptors are expressed in various tissues of the body either as single ones or together. A growing literature suggests that the melatonergic system may be involved in the pathophysiology of mood and anxiety disorders. In fact, some core symptoms of depression show disturbance of the circadian rhythm in their clinical expression, such as diurnal mood and other symptomatic variation, or are closely linked to circadian system functioning, such as sleep-wake cycle alterations. In addition, alterations have been described in the circadian rhythms of several biological markers in depressed patients. Therefore, there is interest in developing antidepressants that have a chronobiotic effect (i.e., treatment of circadian rhythm disorders). As melatonin produces chronobiotic effects, efforts have been aimed at developing agomelatine, an antidepressant with melatonin agonist activity. The present paper reviews the role of the melatonergic system in the pathophysiology of mood and anxiety disorders and the clinical characteristics of agomelatine. Implications of agomelatine in "real world" clinical practice will be also discussed.
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Affiliation(s)
- Domenico De Berardis
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4 Teramo, Italy; E-Mail:
- Department of Neuroscience and Imaging, Chair of Psychiatry, University “G. D’Annunzio”, Chieti 66013, Italy; E-Mails: (G.M.); (M. G.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-0861429708; Fax: +39-0861429706
| | - Stefano Marini
- National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL 4 Teramo, Italy; E-Mail:
- Department of Neuroscience and Imaging, Chair of Psychiatry, University “G. D’Annunzio”, Chieti 66013, Italy; E-Mails: (G.M.); (M. G.)
| | - Michele Fornaro
- Department of “Scienze della Formazione”, University of Catania, Catania 95121, Italy; E-Mail:
| | - Venkataramanujam Srinivasan
- Sri Sathya Sai Medical Educational and Research Foundation, Medical Sciences Research Study Center, Prasanthi Nilayam, 40-Kovai Thirunagar Coimbatore, Tamilnadu 641014, India; E-Mail:
| | - Felice Iasevoli
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine “Federico II”, Naples 80131, Italy; E-Mails: (F.I.); (C.T.)
| | - Carmine Tomasetti
- Laboratory of Molecular Psychiatry and Psychopharmacotherapeutics, Section of Psychiatry, Department of Neuroscience, University School of Medicine “Federico II”, Naples 80131, Italy; E-Mails: (F.I.); (C.T.)
| | - Alessandro Valchera
- Hermanas Hospitalarias, FoRiPsi, Villa S. Giuseppe Hospital, Ascoli Piceno 63100, Italy; E-Mail:
| | - Giampaolo Perna
- Hermanas Hospitalarias, FoRiPsi, Department of Clinical Neurosciences, Villa San Benedetto Menni, Albese con Cassano, Como 22032, Italy; E-Mail:
- Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, 33124 Miami, USA
- Department of Psychiatry and Neuropsychology, University of Maastricht, 6200 MD Maastricht, The Netherlands
| | - Maria-Antonia Quera-Salva
- AP-HP Sleep Unit, Department of Physiology, Raymond Poincaré Hospital, Garches 92380, France; E-Mail:
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Chair of Psychiatry, University “G. D’Annunzio”, Chieti 66013, Italy; E-Mails: (G.M.); (M. G.)
| | - Massimo di Giannantonio
- Department of Neuroscience and Imaging, Chair of Psychiatry, University “G. D’Annunzio”, Chieti 66013, Italy; E-Mails: (G.M.); (M. G.)
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9
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Kripke DF, Nievergelt CM, Tranah GJ, Murray SS, McCarthy MJ, Rex KM, Parimi N, Kelsoe JR. Polymorphisms in melatonin synthesis pathways: possible influences on depression. J Circadian Rhythms 2011; 9:8. [PMID: 21827647 PMCID: PMC3177871 DOI: 10.1186/1740-3391-9-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 08/09/2011] [Indexed: 11/14/2022] Open
Abstract
Background It has been reported that rs4446909, a single nucleotide polymorphism (SNP) in the promoter of acetylserotonin methyltransferase (ASMT), influences the expression of the ASMT enzyme. The common G allele is associated with lower ASMT activity, and therefore, diminishes conversion of N-acetylserotonin to melatonin. The G allele was associated with recurrent depressive disorder in a Polish group. ASMT might also affect bipolar relapse, given evidence that N-acetylserotonin might stimulate TRKB receptors, and TRKB may influence mood relapse in bipolar disorder. Additionally, arylalkylamine N-acetyltransferase (AANAT) polymorphisms have been reported associated with depression, perhaps through their influence upon N-acetylserotonin or melatonin synthesis. Results To replicate and further explore these ideas, rs4446909 was genotyped in four research groups, as part of a panel of 610 SNPs surveyed by an Illumina Golden Gate assay. In 768 cases with delayed sleep phase disorder or matched controls, rs4446909 was indeed associated with the depressive symptoms on a self-report scale (P = 0.01, R2 = 0.007). However, there was no significant association of rs4446909 with self-reported depression in a sleep clinic patient group or with two groups of elderly men and women from multicenter studies, nor was the response to lithium treatment associated with rs4446909 in bipolar patients. No associations of two AANAT SNPs with depression were found. Conclusions The evidence did not support a strong influence of rs4446909 upon mood, but the partial replication may be consistent with a modest effect. It is possible that larger or younger subject groups with improved phenotype ascertainment might demonstrate more persuasive replication.
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Affiliation(s)
- Daniel F Kripke
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA.
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10
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Carvalho LA, Gorenstein C, Moreno R, Pariante C, Markus RP. Effect of antidepressants on melatonin metabolite in depressed patients. J Psychopharmacol 2009; 23:315-21. [PMID: 18562432 DOI: 10.1177/0269881108089871] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Antidepressants increase melatonin levels, but it is still unclear whether this effect is related to the improvement of depressive symptoms or to unrelated pharmacological action of antidepressants. To answer this question, the effect of antidepressants on 6-sulphatoxymelatonin (aMT6s), the main melatonin urinary metabolite, was examined in drug-free depressed patients - most of them antidepressant-naive. aMT6s was evaluated in 34 depressed patients, before and after 8 weeks of placebo (n = 12) or antidepressant (n = 22; fluoxetine, duloxetine or Hypericum perforatum). Both groups showed an improvement of depressive symptoms after treatment compared to baseline (Hamilton Depression scores): 17.0 +/- 1.4 vs. 9.0 +/- 2.8, P = 0.007 for placebo, and 18.6 +/- 1.1 vs. 11.8 +/- 1.6, P < 0.001 for antidepressants). After treatment, aMT6s levels increased after antidepressants (P < 0.01), but not after placebo (P > 0.05). As depressive symptoms improved both in patients taking antidepressant and in those taking placebo, but an effect of antidepressants could only be seen in those taking antidepressants, we suggest that melatonin changes after antidepressants are more likely due to a pharmacological action of these drugs on melatonin secretion.
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Affiliation(s)
- Livia A Carvalho
- Department of Psychological Medicine, Section and Laboratory of Stress Psychiatry and Immunology, Institute of Psychiatry, Kings College London, London, UK.
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11
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Parry BL, Meliska CJ, Martínez LF, López AM, Sorenson DL, Hauger RL, Elliott JA. Late, but not early, wake therapy reduces morning plasma melatonin: relationship to mood in Premenstrual Dysphoric Disorder. Psychiatry Res 2008; 161:76-86. [PMID: 18789826 PMCID: PMC3038844 DOI: 10.1016/j.psychres.2007.11.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Revised: 10/11/2007] [Accepted: 11/11/2007] [Indexed: 11/30/2022]
Abstract
Wake therapy improves mood in Premenstrual Dysphoric Disorder (PMDD), a depressive disorder in DSM-IV. We tested the hypothesis that the therapeutic effect of wake therapy in PMDD is mediated by altering sleep phase with melatonin secretion. We measured plasma melatonin every 30 min (18:00-09:00 h) in 19 PMDD and 18 normal control (NC) women during mid-follicular (MF) and late luteal (LL) menstrual cycle phases, and during LL interventions with early wake therapy (EWT) (sleep 03:00-07:00 h)(control condition) vs. late wake therapy (LWT) (sleep 21:00-01:00 h)(active condition). Melatonin offset was delayed and duration was longer in the symptomatic LL vs. asymptomatic MF phase in both NC and PMDD subjects. LWT, but not EWT, advanced offset and shortened duration vs. the LL baseline, although they improved mood equally. Later baseline LL morning melatonin offset was associated with more depressed mood in PMDD patients, and longer melatonin duration in the MF phase predicted greater mood improvement following LWT. That LWT, but not EWT, advanced melatonin offset and shortened duration while they were equally effective in improving mood suggests that decreasing morning melatonin secretion is not necessary for the therapeutic effects of wake therapy in PMDD.
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Affiliation(s)
- Barbara L. Parry
- Department of Psychiatry, University of California, San Diego,San Diego Veterans Affairs Healthcare System,Address correspondence to: Barbara L. Parry, M.D., Professor of Psychiatry, University of California, San Diego, Mailcode 0804, 9500 Gilman Dr., La Jolla, CA 92093-0804, Phone: 619 543-5592, Fax: 619 543-7519,
| | | | | | - Ana M. López
- Department of Psychiatry, University of California, San Diego
| | | | - Richard L. Hauger
- Department of Psychiatry, University of California, San Diego,San Diego Veterans Affairs Healthcare System
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12
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Parry BL, Meliska CJ, Sorenson DL, López AM, Martínez LF, Nowakowski S, Hauger RL, Elliott JA. Increased melatonin and delayed offset in menopausal depression: role of years past menopause, follicle-stimulating hormone, sleep end time, and body mass index. J Clin Endocrinol Metab 2008; 93:54-60. [PMID: 18042653 PMCID: PMC2190736 DOI: 10.1210/jc.2006-2853] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The constellation of endocrine patterns accompanying menopausal depression remains incompletely characterized. OBJECTIVE Our objective was to test the hypothesis that the amplitude or phase (timing) of melatonin circadian rhythms differs in menopausal depressed patients (DP) vs. normal controls women (NC). DESIGN We measured plasma melatonin every 30 min from 1800-1000 h in dim light (<30 lux) or dark, serum gonadotropins and steroids (1800 and 0600 h), and mood (Hamilton and Beck depression ratings). SETTING The study was conducted at a university hospital. PARTICIPANTS AND SETTING Twenty-nine (18 NC, 11 DP) peri- or postmenopausal women participated. MAIN OUTCOME MEASURES We measured plasma melatonin (onset, offset, synthesis offset, duration, peak concentration, and area under the curve) and mood. RESULTS Multi- and univariate analyses of covariance showed that melatonin offset time was delayed (P = 0.045) and plasma melatonin was elevated in DP compared with NC (P = 0.044) across time intervals. Multiple regression analyses showed that years past menopause predicted melatonin duration and that melatonin duration, body mass index, years past menopause, FSH level, and sleep end time were significant predictors of baseline Hamilton (P = 0.0003) and Beck (P = 0.00004) depression scores. CONCLUSIONS Increased melatonin secretion that is phase delayed into the morning characterized menopausal DP vs. NC. Years past menopause, FSH, sleep end time, and body mass index may modulate effects of altered melatonin secretion in menopausal depression.
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Affiliation(s)
- Barbara L Parry
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093-0804, USA.
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13
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Lader M. Limitations of current medical treatments for depression: disturbed circadian rhythms as a possible therapeutic target. Eur Neuropsychopharmacol 2007; 17:743-55. [PMID: 17624740 DOI: 10.1016/j.euroneuro.2007.05.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2006] [Revised: 05/16/2007] [Accepted: 05/24/2007] [Indexed: 12/01/2022]
Abstract
The proportion of diagnosed depressives prescribed antidepressants has increased markedly over the last 20 years, mainly following the introduction of the selective serotonin reuptake inhibitors. However, currently available antidepressants have notable limitations, relating to their only moderate efficacy relative to placebo, relatively slow onset of action, possible withdrawal symptoms, and problems of compliance. Sleep disturbances are often used to identify newly presenting depressive patients, and may be part of a more general alteration of bodily rhythms. There are links between pharmacological treatments and circadian rhythms in depression, which might represent another, new option for the development of a therapeutic approach to depression treatment. Many antidepressants affect sleep, some are sedative, and others have been used specifically in severely insomniac depressives. Disturbances in circadian rhythms may be an integral part of depressive mechanisms, and normalising them via an innovative mechanism of antidepressant action may be a fruitful avenue in the search for improved antidepressant agents.
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Affiliation(s)
- Malcolm Lader
- PO Box 56, Institute of Psychiatry, Denmark Hill, London SE5 8AF, United Kingdom.
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Affiliation(s)
- R Bordet
- Département de Pharmacologie médicale, Institut de Médecine Prédictive et de Recherche Thérapeutique, Faculté de Médecine-Université de Lille 2, Centre Hospitalier et Universitaire de Lille
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Carvalho LA, Gorenstein C, Moreno RA, Markus RP. Melatonin levels in drug-free patients with major depression from the southern hemisphere. Psychoneuroendocrinology 2006; 31:761-8. [PMID: 16621322 DOI: 10.1016/j.psyneuen.2006.02.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Revised: 02/28/2006] [Accepted: 02/28/2006] [Indexed: 11/20/2022]
Abstract
The secretion of melatonin has been shown as abnormal in some depressed patients, but most such studies were conducted in the northern hemisphere and with severely depressed inpatients. The aim of this study was to evaluate melatonin excretion profiles in major depressive outpatients from São Paulo, Brazil, individually matched to well-screened healthy volunteers to examine whether melatonin abnormalities are also present in patients from the southern hemisphere, and in less severely ill patients. We analyzed 32 drug-free, depressed outpatients and 32 psychiatrically healthy volunteers matched for age and gender. We also examined a set of 15 drug-free depressed outpatients and 15 healthy volunteers that were matched not only for age and gender, but also for body mass index and season, all factors known to influence melatonin excretion in humans. All patients fulfilled DSM-IV criteria for major depression. We evaluated major urinary metabolite of melatonin, 6-sulphatoxymelatonin (aMT6s), produced over 24 h and divided into four periods (06:00-12:00, 12:00-08:00, 18:00-24:00 and 24:00-06:00 h). aMT6s measurements during the 24 and 6 h intervals were similar in the 32 depressed patients and 32 healthy volunteers matched for age and gender; further matching for body mass index and season did not alter the results. Our study supports others in which depressed patients were found to have similar melatonin levels than healthy volunteers. Melatonin excretion has been considered a physiological index for noradrenergic function, which in some studies were found to be altered than depressed patients. It is conceivable that the alteration of nocturnal melatonin in depressed patients occurs only in more severe depression.
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Affiliation(s)
- Livia A Carvalho
- Department of Physiology, Institute of Biosciences, Universidade de São Paulo, Rua do Matão, travessa 14 sala 323, CEP 05508-900 São Paulo, SP, Brazil.
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Parry BL, Fernando Martínez L, Maurer EL, López AM, Sorenson D, Meliska CJ. Sleep, rhythms and women's mood. Part II. Menopause. Sleep Med Rev 2006; 10:197-208. [PMID: 16618548 DOI: 10.1016/j.smrv.2005.09.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review summarizes studies of sleep and other biological rhythms in menopausal women with major depression compared with healthy control subjects. Where feasible, we focused on studies in women who met DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for a major depressive episode (MDE) compared with matched normal control subjects and the Staging System for Reproductive Aging in Women (STRAW) criteria. The aim was to review supporting evidence for the hypothesis that a disruption of the normal temporal relationship between sleep and other biological rhythms, such as melatonin, cortisol, thyroid stimulating hormone (TSH) or prolactin, occur during the menopausal transition. As a result, depressive disorders occur in predisposed women. Treatment strategies, designed to correct these altered phase (timing) or amplitude abnormalities, thereby improve mood. Although there may be some common features to menopausal depression compared with other depressive disorders related to the reproductive cycle (e.g. premenstrual dysphoric disorder or postpartum major depression), such as increased morning melatonin secretion, a specific profile of sleep and biological rhythms may distinguish healthy from depressed women during menopause. Further work is needed to characterize more fully the particular abnormalities associated with well-defined menopausal depression in order to develop treatment strategies targeted more specifically to pathogenesis.
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Affiliation(s)
- Barbara L Parry
- Department of Psychiatry 0804, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0804, USA.
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Current awareness in geriatric psychiatry. Int J Geriatr Psychiatry 2003; 18:1067-74. [PMID: 14661646 DOI: 10.1002/gps.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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