Abstract
The objective of this work was to study circadian rhythms of the indicators of the spectral analysis of the heart rate variability in case of depression. A total of 37 patients, with a mean age of 46.7+/-10.3 years, were examined. According to the International Classification of Disease, 10th revision (ICD-10), endogenous depression was diagnosed for all of them (F 31.3-31.4, F 32.0-32.2, F 33.0-33.2). To assess the variability of the heart rhythm, the spectral analysis was used. The patients were examined at 1 AM, 7 AM, 1 PM, 7 PM prior to the beginning of treatment, following one week, and upon leaving the inpatient department. The control group consisted of 15 mentally healthy people. Before the beginning of treatment, desynchronization of circadian rhythms of the indicators studied and the sleep-wake cycle, the increase in the spectrum power within low-frequency (LF) range, and the decrease in the spectrum power within high-frequency (HF) range were observed. Reduction of depression symptoms was followed by resynchronization of the rhythms under study, with a spectrum power within LF range being increased and that within HF range--decreased. Changes in depression symptoms and chronobiological disorders testify to their close pathogenetic link.
Highlights
Major depression is the most common mental illness in the general population, with a lifetime prevalence of 4–18% [1]
Changes in depression symptoms and chronobiological disorders testify to their close pathogenetic link
Since the role of chronobiological disorders in the pathogenesis of depression is rather vague, the study of the question of correlation between the clinical manifestation of depression and the disturbance of circadian rhythms is of great interest
Summary
Major depression is the most common mental illness in the general population, with a lifetime prevalence of 4–18% [1]. Polysomnographic investigations revealed that the decrease in the length of a slow-wave sleep, the reduction of the latent period of the rapid eye movement (REM) phase, the disturbance of markers of its continuity are characteristic of a depressive episode [12] These changes attest to desynchronization of the circadian rhythms and the sleep-wake cycle, the shift of their phases towards the earlier hours of the day. Periodicity in affective disorders (from seasonal recurrence to 48-h rapid cycling) is the clinical observation; diurnal variation of mood, early morning awakening, and sleep disturbances are the classical symptoms that have linked depression with circadian rhythm function Many rhythms, such as core body temperature, cortisol, monoamine metabolism, are different in depressive patients: phase advanced (timed earlier) with respect to the sleep-wake cycle, diminished in amplitude, and/ or with day-to-day variability in their synchronization to social cues [13]. Since the role of chronobiological disorders in the pathogenesis of depression is rather vague, the study of the question of correlation between the clinical manifestation of depression and the disturbance of circadian rhythms is of great interest
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