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de Leeuw M, Verhoeve SI, van der Wee NJA, van Hemert AM, Vreugdenhil E, Coomans CP. The role of the circadian system in the etiology of depression. Neurosci Biobehav Rev 2023; 153:105383. [PMID: 37678570 DOI: 10.1016/j.neubiorev.2023.105383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/19/2023] [Accepted: 09/02/2023] [Indexed: 09/09/2023]
Abstract
Circadian rhythms have evolved in almost all organisms enabling them to anticipate alternating changes in the environment. As a consequence, the circadian clock controls a broad range of bodily functions including appetite, sleep, activity and cortisol levels. The circadian clock synchronizes itself to the external world mainly by environmental light cues and can be disturbed by a variety of factors, including shift-work, jet-lag, stress, ageing and artificial light at night. Interestingly, mood has also been shown to follow a diurnal rhythm. Moreover, circadian disruption has been associated with various mood disorders and patients suffering from depression have irregular biological rhythms in sleep, appetite, activity and cortisol levels suggesting that circadian rhythmicity is crucially involved in the etiology and pathophysiology of depression. The aim of the present review is to give an overview and discuss recent findings in both humans and rodents linking a disturbed circadian rhythm to depression. Understanding the relation between a disturbed circadian rhythm and the etiology of depression may lead to novel therapeutic and preventative strategies.
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Affiliation(s)
- Max de Leeuw
- Department of Psychiatry, Leiden University Medical Center, Postal Zone B1-P, P.O. Box 9600, Leiden 2300 RC, the Netherlands; Mental Health Care Rivierduinen, Bipolar Disorder Outpatient Clinic, PO Box 405, Leiden 2300 AK, the Netherlands.
| | - Sanne I Verhoeve
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Postal Zone B1-P, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Postal Zone B1-P, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Erno Vreugdenhil
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, the Netherlands
| | - Claudia P Coomans
- Laboratory for Neurophysiology, Department of Cell and Chemical Biology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, the Netherlands
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Juda M, Pater J, Mistlberger RE, Schütz CG. Sleep and Rest-Activity Rhythms in Recovering Patients with Severe Concurrent Mental and Substance Use Disorder: A Pilot Study. J Dual Diagn 2023; 19:26-39. [PMID: 36580397 DOI: 10.1080/15504263.2022.2157694] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: Mental health and substance use disorders are commonly associated with disrupted sleep and circadian rest-activity rhythms. How these disorders in combination relate to sleep and circadian organization is not well studied. We provide here the first quantitative assessment of sleep and rest-activity rhythms in inpatients with complex concurrent disorders, taking into account categories of substance use (stimulant vs. stimulant and opioid use) and psychiatric diagnosis (psychotic disorder and mood disorder). We also explore how sleep and rest-activity rhythms relate to psychiatric functioning. Methods: A total of 44 participants (10 female) between the age of 20-60 years (median = 29 years) wore wrist accelerometers over 5-70 days and completed standardized questionnaires assessing chronotype and psychiatric functioning (fatigue, psychiatric symptom severity, and impulsiveness). To examine potential influences from treatment, we computed (1) length of stay; (2) days of abstinence from stimulants and opioids as a measure of withdrawal; and (3) a sedative load based on prescribed medications. Results: Participants exhibited a sustained excessive sleep duration, frequent nighttime awakenings, and advanced rest-activity phase related to sedative load. Sleep disruptions were elevated in participants with a history of opioid use. Patients with a psychotic disorder showed the longest sleep and most fragmented and irregular rest-activity patterns. Non-parametric circadian rhythm analysis revealed a high rhythm amplitude by comparison with population norms, and this was associated with greater psychiatric symptom severity. Psychiatric symptom severity was also associated with greater fatigue and later MCTQ chronotype. Conclusions: This pilot study provides initial information on the prevalence and severity of sleep and circadian rhythm disturbances in individuals with severe concurrent disorders. The results underline the need for further studies to start to understand the role of sleep in the disease and recovery process in this understudied population.
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Affiliation(s)
- Myriam Juda
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.,Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Joanna Pater
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada.,Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,School of Medicine, St. George's University, St. George's, Grenada
| | - Ralph E Mistlberger
- Sleep and Circadian Neuroscience Laboratory, Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Christian G Schütz
- Behavioral Reward Affect + Impulsivity Neuroscience (BRAIN) Lab, Department of Psychiatry, Institute of Mental Health, University of British Columbia, Vancouver, Canada.,Provincial Health Services Authority, Red Fish Healing Centre for Mental Health and Addiction, Coquitlam, Canada
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