Biological Rhythm Disturbances Research Articles

The relationship between anxiety symptoms and disturbances in biological rhythms in patients with depression

BackgroundBiological rhythms denote the cyclical patterns of life activities anchored to a 24-hour cycle. Research shows that depression exhibits disturbances in biological rhythms. Yet, the relationship between these biological rhythms and concomitant anxiety symptoms is insufficiently investigated in structured clinical assessments. MethodsThis multicenter study, carried out in four Chinese hospitals, comprehensively examined the relationship between anxiety and disruptions in biological rhythms among patients with depression. The study encompassed 218 patients diagnosed with depression and 205 matched healthy controls. The Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry was utilized to evaluate the participants' biological rhythms, focusing on four dimensions: sleep, activity, social, and diet. ResultsIn patients with depression, there is a significant positive correlation between the severity of anxiety symptoms and the disturbances in biological rhythms. The severity of anxiety and depression, along with the quality of life, are independently associated with disruptions in biological rhythms. The mediation model reveals that anxiety symptoms mediate the relationship between depressive symptoms and biological rhythms. ConclusionThis research highlights the role of anxiety within the spectrum of depressive disorders and the associated disturbances in biological rhythms. Our findings shed light on potential pathways towards more targeted preventive strategies and therapeutic interventions for individuals battling depression and anxiety.

Relationship between biological rhythm dysregulation and suicidal ideation in patients with major depressive disorder

BackgroundAlthough the disturbance of circadian rhythms represents a significant clinical feature of major depressive disorder (MDD), the relationship between biological rhythm disturbances and the severity of suicidal ideation in individuals with MDD remains unclear. We aimed to explore the characteristics of different biological rhythm dimensions in MDD and their association with the severity of depressive symptoms and suicidal ideation.MethodsA total of 50 MDD patients and 50 healthy controls were recruited and their general information was collected. The severity of depressive symptoms was assessed with the 17-item Hamilton Depression Rating Scale (HDRS17). The intensity of suicidal ideation was evaluated with the Beck Scale for Suicide Ideation (BSS). The Chinese version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scale was utilized to assess the participants’ biological rhythm dysregulation. Multiple logistic regression analysis was conducted to explore the relationship between biological rhythm and the risk of MDD. Multiple linear regression analysis was performed in the MDD group to investigate the relationship between different biological rhythm dimensions and suicide ideation.ResultsSignificant differences were observed between the MDD group and the control group in total BRIAN score (Z=-5.41, P < 0.001) as well as scores for each dimension. After adjusting for confounding factors, multiple logistic regression analysis revealed a significant association between total BRIAN score and the presence of MDD (OR = 1.20, 95% CI = 1.10–1.29, P < 0.001), as well as between scores in different BRIAN dimensions and the presence of MDD (activity: OR = 1.47, 95% CI = 1.24–1.74, P < 0.001; sleep: OR = 1.52, 95% CI = 1.28–1.79, P < 0.001; social: OR = 1.80, 95% CI = 1.32–2.46, P < 0.001; eating pattern: OR = 1.34, 95% CI = 1.12–1.60, P = 0.001). In patients with MDD, linear regression analysis demonstrated a positive relationship between BSS scores and BRIAN eating pattern scores (β = 0.34, P = 0.022), even after adjusting for demographic factors and the severity of depression.ConclusionsPatients with MDD exhibited significantly higher levels of dysregulation in all four biological rhythm dimensions compared to healthy controls and the degree of dysregulation was associated with the severity of depression. More importantly, dysregulation of eating pattern may increase the intensity of suicidal ideation in MDD, thus elevating the risk of suicide.

Circadian Rhythms and Sleep Disorders Associated to Major Depressive Disorder: Pathophysiology and Therapeutic Opportunities.

Major depressive disorder (MDD) is a complex mood disorder. While much progress has been made in understanding the pathophysiology of MDD, no single mechanism can explain all facets of this disorder. Several studies show that disturbances in biological rhythms can lead to the development of MDD. Indeed, insomnia or hypersomnia are symptoms included in the MDD diagnostic criteria. Clinical studies and meta-analyses showed a strong relationship between MDD and sleep disorders. Sleep disorder and MDD are associated with activation in the hypothalamicpituitary-adrenal (HPA) axis and inflammation. The increase in inflammatory response can activate the kynurenine pathway, decrease serotonin synthesis, and affect other factors involved in the pathophysiology of neuropsychiatric conditions. Moreover, sleep disorders and MDD can change the gut microbiota and alter the microbiota-gut-brain axis. Thus, this review discusses the relationship between MDD, circadian rhythms, and sleep disorders, describing the potential pathophysiological mechanism shared in these conditions. In addition, therapeutic opportunities based on antiinflammatory, antioxidant, HPA axis regulatory, and synapse-modulating actions are raised. For the article search, we used the PubMed database. Both sleep disorders and changes in biological rhythms have a bidirectional relationship with MDD. Although some pathophysiological mechanisms, including inflammation, changes in the gut microbiota, and decreased neuroplasticity, may be involved in the relationship between sleep, circadian rhythms, and MDD, other mechanisms are not yet well understood. Therapeutic opportunities based on anti-inflammatory, antioxidant, HPA regulatory axis, and synapse modulating actions appear to be promising targets in preventing MDD, circadian rhythm disturbances, and sleep disorders.

Relationship Between Biological Rhythm and Food Addiction in Obesity

Objective: Obesity is a common, multifactorial, and epigenetic disease. Emotional eating and food addiction are common eating behaviors in obese people. Biological rhythm helps the body adapt to the light-dark cycle and relates to eating behavior, including obesity. Thus, the study aims to reveal whether food addiction, an important factor in obesity, is affected by biological rhythm.Methods: A total of 130 participants (obese=76, nonobese=54) participated in the study. All participant’s anthropometrics were recorded. Beck Depression and Anxiety Inventories (BDI and BAI) were obtained. Afterward, the Yale Food Addiction Scale (YFAS) form was filled out to evaluate food addiction. Finally, they were asked to fill in the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) form to assess biological rhythm.Results: Obese and nonobese subjects had a significant positive correlation with body mass index (BMI), fat mass, fat-free mass, body fat percentage, and YFAS between weight (p&lt;0.001). BRIAN chronotype score and BMI were negatively correlated between obese subjects (p&lt;0.05) but not in nonobese subjects. BDI and BAI were significantly positively correlated (p&lt;0.05, p&lt;0.001) with BRIAN subscales except for chronotype in obese patients. Thus, higher scores in BRIAN imply greater disturbances in biological rhythms. YFAS results were positively correlated with weight, BDI, BAI, and BRIAN subtype parameters in the obese group. In the nonobese group, there was a positive correlation between YFAS and BDI and no correlation between the YFAS and BRIAN subtype parameters.Conclusion: As a result, if the person is both obese and has been diagnosed with food addiction, obesity may have emerged as a continuation of depression, anxiety, and biological rhythm disruptions.

Desynchronized daily activity rhythms and gender related psychological well-being of Moroccan university students during the quarantine-isolation.

The disturbance of students' biological and academic rhythms induced by the Coronavirus generated considerable challenges that had an influence on their psychological well-being. This study aims to highlight the daily rhythm desynchronization and examine the mental health of Moroccan students who were impacted, notably females, in the context of the COVID-19 pandemic. A cross-sectional online survey was conducted in May 2020 at ten Moroccan faculties including 312 students with an average age of 22 ± 1.70 years old, processed according to a random sampling. A Daily Activities Biorhythm Questionnaire was used to assess the students' daily activities time use and duration, while the PTSD Symptom Scale, Hamilton Scale, Worry Domains Questionnaire, and Visual Analog Mood State Scale were used to assess their mental health. A statistical analysis used both Chi-square and t test to evaluate the relationship between females and males as two independent groups to the studied variables. Based on individual gender differences, a significant disruption emerged in the daily time use and duration of activities during home confinement. Besides, females were more likely to experience psychological issues notably anxiety (2.04 ± 0.49), physical tiredness (2.11 ± 0.39), sadness (p <.05), and posttraumatic stress disorder (p <.01). In contrast, there is a strong correlation between males' concern of declining employment (p <.05) and their worry of declining family budgets (2.10 ± 1.39). As an emerging behavior for a new risk factor, the daily activities rhythm of Moroccan university students have been altered and mental health difficulties have appeared due to the quarantine isolation. This might influence their overall academic performance and psychological balance. In this instance, psychological assistance is highly recommended.

Reliability and validity of the Chinese version of the biological rhythms interview of assessment in neuropsychiatry in patients with major depressive disorder

BackgroundAlthough disturbances in biological rhythms are closely related to the onset of major depressive disorder (MDD), they are not commonly assessed in Chinese clinical practice. The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) has been used to evaluate disturbances in biological rhythms in MDD. We aimed to assess and confirm the reliability and validity of the Chinese version of the BRIAN (C-BRIAN) in patients with MDD.MethodsA total of 120 patients with MDD and 40 age- and sex-matched controls were recruited consecutively. Reliability was estimated using Cronbach’s alpha, the split-half coefficient, and the test-retest coefficient; test-retest reliability was assessed using Spearman’s correlation coefficient. A confirmatory factor analysis was used to determine the construct validity of the scale. The Pittsburgh Sleep Quality Index (PSQI) and the Morningness-Eveningness Questionnaire (MEQ) were used to check concurrent validity by evaluating the correlation between the C-BRIAN, PSQI, and MEQ.ResultsThe overall Cronbach’s α value was 0.898, indicating good internal consistency. The Guttman split-half coefficient was 0.792, indicating good split-half reliability. Moreover, the test-retest reliability for both the total and individual item score was excellent. Confirmatory factor analysis revealed that construct validity was acceptable (χ2/df = 2.117, GFI = 0.80, AGFI = 0.87, CFI = 0.848, and RMSEA = 0.097). Furthermore, total BRIAN scores were found to be negatively correlated with MEQ (r = − 0.517, P < 0.001) and positively correlated with PSQI (r = 0.586, P < 0.001). In addition, patients with MDD had higher BRIAN scores than those in controls.ConclusionsThis study revealed that the C-BRIAN scale has great validity and reliability in evaluating the disturbance of biological rhythms in patients with MDD.

Tumor markers and depression scores are predictive of non-suicidal self-injury behaviors among adolescents with depressive disorder: A retrospective study

BackgroundNon-suicidal self-injury (NSSI) is an important risk factor for suicide in adolescents with depressive disorders; therefore, it is important to predict NSSI occurrence as early as possible. Disturbances in biological rhythms are characteristic manifestations of depressive disorders and can lead to immune dysfunction, leading to changes in tumor markers. This study aimed to produce an index that utilizes tumor markers to predict NSSI behaviors among adolescents with depressive disorders.MethodsA total of 120 hospitalized adolescent patients with depressive disorders aged 14–24 years were included in this study. Participants were divided into NSSI and non-NSSI groups based on self-reports using the Ottawa Self-Injury Inventory. Demographics, tumor marker concentrations, other peripheral blood indices, Hamilton Depression Rating Scale (HDRS) scores, and Hamilton Anxiety Rating Scale (HAMA) scores were compared between the two groups. Logistic regression analysis was conducted to develop a joint index, and a receiver operating characteristic (ROC) curve was created to predict NSSI behaviors among adolescents with depressive disorders.ResultsCompared with the non-NSSI group, the NSSI group had significantly higher insight, retardation, insomnia, hopelessness, psychiatric anxiety, total HDRS and HAMA scores, and significantly higher levels of cancer antigen 125 (CA-125), cancer antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA). In addition, a joint index was developed by combining CA-125, CA19-9, CEA, HDRS total score, HAMA total score and age using multiple logistic regression to predict NSSI behaviors. The area under the curve was 0.831, with a sensitivity and specificity of 0.734 and 0.891, respectively.ConclusionA combination of depression score, tumor marker levels, and age can identify NSSI behaviors among adolescents with depressive disorders.

Perceived stress and depressive symptoms among Chinese college students: A moderated mediation model of biorhythm and ego resilience.

ObjectiveTo explore whether biological rhythm disturbance mediates the association between perceived stress and depressive symptoms and to investigate whether ego resilience moderates the mediation model.MethodsA cross-sectional study was carried out using an online self-report questionnaire distributed to college students from September 2021 to October 2021. Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Severity (PSS-10), the Biological Rhythms Assessment in Neuropsychiatry (BRIAN), and Ego Resilience (ER-96) were used for investigation. SPSS 23 was used for data analyses. The significance of mediation was determined by the PROCESS macro using a bootstrap approach.ResultsAmong the participants, 9.2% (N = 1,282) exhibited significant symptoms of depression. Perceived stress was positively associated with depressive symptoms, and biorhythm partially mediated this relationship. The direct and indirect effects were both moderated by ego resilience. Perceived stress had a greater impact on depressive symptoms and biorhythm for college students with lower ego resilience, and the impact of biorhythm on depressive symptoms was also stronger for those with lower ego resilience. Perceived stress had an impact on depressive symptoms directly and indirectly via the mediation of biorhythm.ConclusionSchools and educators should guide college students to identify stress correctly and provide effective suggestions to deal with it. Meanwhile, maintaining a stable biorhythm can protect college students from developing depressive symptoms. Students with low resilience should be given more attention and assistance.

CIRCADIAN RHYTHMS REGULATED ASTHMA TREATMENT BY VIRTUE OF PULSATILE DRUG DELIVERY SYSTEM

Asthma, as we all know, is a disease that shows a high tendency of chronic inflammation in the airways, which associates with airflow obstruction. Lung function seems to be decreased in the case of people suffering from asthma. On reviewing many studies from the past, clear statements come out which also revealed that asthma is based on established circadian rhythm. Asthma is considered to be one of the diseases which affects majorly common in adult women than in men; according to numerous studies, 42 percent of persons with active asthma claimed that their asthma started before they were 16 y old. The pulsatile drug delivery system, an innovation in pharmaceutical technology, is generating huge attention these days and is alleged to be the most productive in the treatment of asthma as per many studies. Many pulsatile delivery system components, such as the osmotic system, capsular system, and single and multiple-unit system, are utilized to diagnose and treat diseases caused by biological rhythm disturbances. Various emerging diseases such as cardiovascular, peptic ulcer, asthma, peptic ulcer, diabetes mellitus, cancer, and hypercholesterolemia have been examined by fluctuation in biological rhythms and treated by a pulsatile drug delivery system. During this era, the pulsatile drug delivery system delivers the medicine at the right time duration, in the right place, and the right proportion and the effectiveness of pulsatile drug delivery on asthma have indeed been investigated in this article.

Mental state, biological rhythm and social support among healthcare workers during the early stages of the COVID-19 epidemic in Wuhan

BackgroundThe COVID-19 pandemic has put the mental health of healthcare workers at risk. However, the potential psychosocial factors underlying mental health problems, such as depression and anxiety, require further investigation. The present study aimed to explore the factors that influence the mental state of healthcare workers. MethodsA total of 276 healthcare workers completed a set of online self-report questionnaires from February 4 to 7, 2020, in the following order: general information related to the COVID-19 outbreak, Biological Rhythms Interview of Assessment in Neuropsychiatry, Beck Depression Inventory-II, Beck Anxiety Inventory, and Social Support Rating Scale. ResultsOur study revealed that both social support and age moderated the ability of biological rhythm disturbance to exacerbate depression (R2 = 0.47; effect size f2 = 0.85). Higher levels of social support buffered the amplification of depression associated with increased biological rhythm disturbance in all age groups, and especially in younger individuals (mean age = 26.57, se = 0.04). Depressive symptoms were predicted by both social and sleeping rhythms, whereas anxiety symptoms were predicted only by social rhythm. Married individuals had lower biological rhythm disturbance ratings and higher social support ratings. Females also reported higher ratings in social support. ConclusionsOur study suggests that biological rhythm intervention along with social support can reduce the negative effect of biological rhythm disturbance on mood disorders, especially in younger people. We also provide evidence for the ability of social support to buffer stress in a major health crisis and demonstrate the effects of marital status and sex, which provide a different perspective for studying mental crisis management.

A Systematic Review for Establishing Relevant Environmental Parameters for Urban Lighting: Translating Research into Practice

The application of lighting technologies developed in the 20th century has increased the brightness and changed the spectral composition of nocturnal night-time habitats and night skies across urban, peri-urban, rural, and pristine landscapes, and subsequently, researchers have observed the disturbance of biological rhythms of flora and fauna. To reduce these impacts, it is essential to translate relevant knowledge about the potential adverse effects of artificial light at night (ALAN) from research into applicable urban lighting practice. Therefore, the aim of this paper is to identify and report, via a systematic review, the effects of exposure to different physical properties of artificial light sources on various organism groups, including plants, arthropods, insects, spiders, fish, amphibians, reptiles, birds, and non-human mammals (including bats, rodents, and primates). PRISMA 2020 guidelines were used to identify a total of 1417 studies from Web of Science and PubMed. In 216 studies, diverse behavioral and physiological responses were observed across taxa when organisms were exposed to ALAN. The studies showed that the responses were dependent on high illuminance levels, duration of light exposure, and unnatural color spectra at night and also highlighted where research gaps remain in the domains of ALAN research and urban lighting practice. To avoid misinterpretation, and to define a common language, key terminologies and definitions connected to natural and artificial light have been provided. Furthermore, the adverse impacts of ALAN urgently need to be better researched, understood, and managed for the development of future lighting guidelines and standards to optimize sustainable design applications that preserve night-time environment(s) and their inhabiting flora and fauna.

Sleep and circadian rhythm characteristics in individuals from the general population during the French COVID-19 full lockdown.

SummaryThe full 2‐month lockdown to fight the coronavirus disease 2019 (COVID‐19) pandemic in 2020 led to substantial disruption of daily life and routines. The present study aimed to comprehensively identify the lockdown’s effects on sleep, daily rhythms and emotions of the French population. A survey was published online during the last week of the 2‐month full lockdown and 1,627 individuals completed the online survey. The survey was self‐administered and included standardised questionnaires. Sleep schedules were delayed during lockdown in more than half of the participants. New severe delayed sleep phase affected 10% of participants with sleep schedules delayed by ≥3 hr during the lockdown compared to before. A significant decrease in exposure to morning (p < 0.001) and evening natural light (p < 0.001), a significant increase in screen exposure time (with a significant screen exposure >3 hr during the evening for 45% of the participants during lockdown versus 18% before lockdown, p < 0.001), an increase in substance use for one‐quarter of participants, a poorer sleep quality in 56% of participants, and less regular sleep schedules in 48% of participants were observed. We also found a poorer sleep quality in women than men during lockdown (p = 0.004). The French full lockdown had a severe impact on sleep quality, sleep–wake rhythms, and sleep behaviours. The implementation of public health strategies for the prevention and care of sleep–wake cycles during lockdown are therefore essential.

Implications of Argentine Tango for Health Promotion, Physical Well-Being as Well as Emotional, Personal and Social Life on a Group of Women Who Dance.

Background: The aim of the research was to determine the effect that dance has on the promotion of health, physical well-being, as well as the emotional, personal and social life of women who dance. In addition, the impact of the physical activity of long, often all-night dancing events on women’s health was investigated. This included possible disturbances in their monthly cycle and circadian rhythm, taking into account symptoms of biological rhythm disturbances. Methods: The study involved 214 women: tango group: 109, sedentary group: 105. The Mann–Whitney U and chi2 tests were used to compare the groups, as well as multiple ordinal regression to analyse individual predictors of missed menstrual periods. Results: The tango vs. sedentary groups did not differ in the duration of menstrual bleeding, the degree of pain during menstruation, the regularity of menstruation, the number of regular monthly cycles per year, and amenorrhea. Intermenstrual spotting was more common in dancers (tango 12.8% vs. sedentary 4.8%; p = 0.038). The frequency of missed periods was not increased by any of the assessed aspects. In 59.6% of female dancers, milongas caused disturbances in circadian rhythms, including extreme fatigue and drowsiness (36.7%), 66.0% of the dancers mentioned only positive aspects of Argentine Tango’s impact on their personal life. Conclusions: tango plays a positive and multifaceted role in the lives of dancers and fulfils the need for social contact. The physical effort put into this form of physical activity does not significantly affect the menstrual cycle, and thus the reproductive functions, and can be recommended as an attractive and safe form of physical recreation for women.

PROBLEMS OF LEGALIZING THE USE OF GENETIC TECHNOLOGIES AND CIRCADIAN PHYSIOLOGY DATA IN THE PROFESSIONAL SELECTION SYSTEM

The article poses the problem of the need to take into account various individual physiological and mental characteristics of a person when conducting professional selection in connection with the expansion of the scope of professional activity. It is considered possible and expedient to solve the problem from the perspective of an integrated approach based, inter alia, on modern DNA technologies that make it possible to draw up genetic maps of a persons predisposition to a particular type of professional activity. In this regard, it is proposed to form an appropriate regulatory legal framework consisting of three main blocks that determine the legal regime of genetic information and scientific research in this area; principles and procedures for genetic passportization; professional standards, in established cases taking into account, in particular, the factor of this predisposition. The article considers the question of the role of biological rhythms in the structure of professional adaptation and the need to take them into account when forming a general conclusion about a persons potential correspondence to a certain professional activity, which has not been covered in the doctrine. The conclusion is drawn on the need for further interdisciplinary research of the problem and optimization of the legal regulation of relations in the field of professional activity associated with the risk of circadian biological rhythm disturbances.

Clinical evaluation of biological rhythm domains in patients with major depression.

Objective:Sleep, physical activity, and social domains of biological rhythm disruptions may have specific effects on the symptom cluster and severity of depression. However, there is a lack of structured clinical evaluation to specify the domains of biological rhythms in patients with depression.Methods:Ninety drug-naïve subjects with depression and 91 matched healthy controls were recruited for the study. The severity of depression was examined with the Hamilton Rating Scale for Depression (HRSD), while biological rhythm was evaluated using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN).Results:Patients with depression showed significantly greater biological rhythm disturbances than healthy controls in all domains of BRIAN (sleep, activity, social, and eating). BRIAN-Total correlated positively with HRSD-Total and HRSD-Total without sleep cluster. The sleep and activity domains correlated significantly with HRSD-Total score. Additionally, the sleep, activity, and social domains correlated significantly with HRSD-Total without the sleep cluster score. Regression analysis revealed the activity (β = 0.476, t = 5.07, p<0.001) and sleep (β = 0.209, t = 2.056, p = 0.043) domains may predict HRSD-Total score.Conclusion:Consideration of biological rhythm domains in clinical examination and focusing on the sleep and activity domains may hold promise for the management of depression.

Biological rhythm disturbances in depression

Depression belongs to the diseases with pronounced medical and social consequences, which include disability, reduced social functioning and suicides. There is the evidence that the depressive manifestations are closely related to disorders of circadian periodism and the function of the suprachiasmatic nuclei of the hypothalamus, the leading driver of biological rhythms. Authors reviewed the possibility to apply the concept of biological rhythms to the development and clinical features of depressive disorder. The potential effects of chronobiotic drugs like melatonin agonists is discussed.

Similarities of Aspects of Biological Rhythms between Major Depression and Bipolar II Disorder Compared to Bipolar I Disorder: A Finding from the Early-Onset Mood Disorder Cohort.

ObjectiveThe biological rhythm is closely related to mood symptoms. The purpose of this study was to assess the differences in biological rhythms among subjects with mood disorder [bipolar I disorder (BD I), bipolar II disorder (BD II), major depressive disorder (MDD)] and healthy control subjects. MethodsA total of 462 early-onset mood disorder subjects were recruited from nine hospitals. The controls subjects were recruited from the general population of South Korea. Subject groups and control subject were evaluated for the Korean language version of Biological Rhythms Interview of Assessment in Neuropsychiatry (K-BRIAN) at the initial evaluation. ResultsThe mean K-BRIAN scores were 35.59 [standard deviation (SD)=13.37] for BD I, 43.05 (SD=11.85) for BD II, 43.55 (SD=12.22) for MDD, and 29.1 (SD=8.15) for the control group. In the case of mood disorders, biological rhythm disturbances were greater than that in the control group (p<0.05). A significant difference existed between BD I and BD II (BD I <BD II, p<0.001) and between BD I and MDD (BD I<MDD, p< 0.001) but no difference was observed between BD II and MDD. ConclusionBD II and MDD are similar to each other but different from BD I in biological rhythm patterns in early-onset mood disorder cases. Biological rhythm disturbances are similar for early-onset major depression and BD II.

SOME TRENDS OF CLINICAL AND SYMPTOMATIC PATHOMORPHOSIS OF DEPRESSIVE DISORDERS TAKING INTO ACCOUNT THE AGE FACTOR

Introduction: Depressive disorders are one of the most complex and pressing problems of modern psychiatry; important scientific and practical importance is the study of the pathomorphosis of depression. The aim of the study is to study the features of clinical pathomorphosis of depressive disorders, taking into account the age factor. Materials and methods: Medical documentation of 115 men and 121 women with depressive disorders who applied for psychiatric care in 1971-1995 were studied, and 81 men and 108 women with similar depressive disorders who applied for medical care in 2015-2018 were examined clinically. Results and conclusions: In modern patients, pathomorphosis is most pronounced in young patients (under 30 years of age): asthenia and pessimism were more common in them (65.9% versus 81.9%, p<0.05), suicidal thoughts (52.7% versus 68,7%, p<0.05), dyssomnias. In this age group, there was a decrease in anesthetic symptoms (34.8% versus 12.2%, p<0.01) with an increase in depressions with psychopathological symptoms, mainly in the form of obsessions (42.9% versus 59.0%, p<0,05), depressions with disturbances of biological rhythms, mainly in the form of postsomnic disorders (73.6% versus 96.4%, p<0.05), with vegetative-somatic disorders (63.7% versus 79.5%, p<0.05), asthenic (67.0% versus 81.9%, p<0.05) and agitated symptoms (26.4% versus 39.8%, p<0.05). In the middle age group (30-44 years), the share of vital forms of depression in the structure of depressive symptoms decreased (65.8% versus 44.6%, p<0.01) and depressions with senesto-algic symptomatology (6.6% against 9.6%, p<0.05). In patients of the older age group (45 years and more), the main trends in clinical pathomorphosis were a decrease in anhedonia (90.9% versus 70.7%, p<0.01) and low self-esteem (89.4% versus 65.9%, p<0.01), as well as an increase in apathetic depressions (13.6% versus 29.3%, p<0.05). The general tendency of modern pathomorphosis of depressive disorders is the reduction of vital forms of depression with an increase in depressions with asthenic, anxious and somatic symptomatology.

Biological Rhythms Advance in Depressive Disorder.

Most processes of human body, such as brain function, are regulated by biological rhythms. Disturbance of biological rhythms impairs mood, behavior, cognition, sleep, and social activity and may lead to mental disorders. Disturbed rhythms are widely observable in patients with major depressive disorders (MDD) and make risk of onset, comorbidity, response of antidepressants, recurrence, cognition, social function, and complications of physical health. Therefore, it is crucial to assess and manage focus on biological rhythms for patients with MDD. There are several validated ways of assessing the biological rhythms, including 24 h fluctuations in cortisol or melatonin, sleep monitoring, actigraphy, and self-report scales. Chronotherapy, such as cognitive-behavioral therapy, interpersonal and social rhythm therapy, sleep deprivation, and brightlight therapy was widely reported for treatment in patients with MDD. Monoamine antidepressants and lithium are attributed to regulation of biological rhythm. And some rhythm-regulated agents have been shown efficacy of antidepressant. Considering the crucial clinical significance of disturbed biological rhythms in MDD, we describe the mechanisms, clinical features, measurements, and treatments of the biological rhythms in patients with MDD.

Clinical features of differential diagnosis between unipolar and bipolar depression in a drug-free sample of young adults

IntroductionSubjects with bipolar disorder suffering of a depressive episode are frequently misdiagnosed as unipolar depression, being important studies assessing the differential diagnosis between bipolar and unipolar depression. ObjectiveTo assess the sociodemographic and clinical features of drug-free young adults in a depressive episode of bipolar or unipolar disorder in order to identify factors that may differentiate these psychiatric conditions. MethodsThis is a cross-sectional study with 241 young adults aged between 18 and 29 years who were evaluated using the Structured Clinical Interview for DSM-IV (SCID). The sample comprised patients with BD (n = 89) and major depressive disorder (n = 152), experiencing a depressive episode and not using psychoactive drugs or illicit psychoactive substances. ResultsThe characteristics associated with bipolar depression were being male (p < 0.001), with a family history of BD (p = 0.013), a higher frequency of childhood traumatic experiences (p = 0.001), younger age of onset of mood disorder (p = 0.004), many previous depressive episodes (p = 0.027), greater severity of depressive symptoms (p < 0.001) and day/night reversal (p = 0.013). Those with unipolar depression showed a higher frequency of biological rhythm disturbances (p < 0.001), and diurnal preference (p = 0.028). LimitationsThe sample has not included subjects with severe suicide risk, a possible important marker in differentiate unipolar from bipolar depression. ConclusionSome clinical aspects may contribute to an early differential diagnosis of both bipolar and unipolar depression even in the initial stages of the disease.