Circadian rhythm disturbances in depression

Germain, Anne; Kupfer, David J.

doi:10.1002/hup.964

Cited by 644Circadian rhythm and melatoninSleep and related disordersTreatment of Major Depression

Circadian rhythm disturbances in depression

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Germain, Anne, Kupfer, David J.·2008·Human Psychopharmacology: Clinical and Experimental

DOI 10.1002/hup.964PMC PMC2612129

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Abstract

Objective: The aim of this article is to review progress in understanding the mechanisms that underlie circadian and sleep rhythms, and their role in the pathogenesis and treatment of depression. Methods: Literature was selected principally by Medline searches, and additional reports were identified based on ongoing research activities in the authors' laboratory. Results: Many physiological processes show circadian rhythms of activity. Sleep and waking are the most obvious circadian rhythms in mammals. There is considerable evidence that circadian and sleep disturbances are important in the pathophysiology of mood disorders. Depressed patients often show altered circadian rhythms, sleep disturbances, and diurnal mood variation. Chronotherapies, including bright light exposure, sleep deprivation, and social rhythm therapies, may be useful adjuncts in non‐seasonal and seasonal depression. Antidepressant drugs have marked effects on circadian processes and sleep. Conclusions: Recent progress in understanding chronobiological and sleep regulation mechanisms may provide novel insights and avenues into the development of new pharmacological and behavioral treatment strategies for mood disorders. Copyright © 2008 John Wiley & Sons, Ltd.

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Most successful treatments of depression, including bright light therapy, wake therapy, social rhythm therapy, and antidepressants such as SSRIs, SNRIs, and agomelatine, directly affect circadian rhythms.
“Most successful treatments of depression, bright light therapy, wake therapy, social rhythm therapy, and antidepressants (SSRIs, SNRIS, and agomelatine) directly affect circadian rhythms83.”
From Circadian rhythm disruption and mental health (2020) · cites this paper as [83]
The sections “Chronotherapies for depression” and “Effects of antidepressant treatments on circadian and sleep rhythms” describe circadian effects of light therapy, a circadian target for social rhythm therapy, and phase advances with agomelatine. They also say wake therapy’s benefits generally disappear after recovery sleep, social rhythm therapy’s efficacy has not been evaluated in unipolar depression, and evidence is limited that circadian processes mediate the effects of SSRIs and SNRIs. Thus the paper supports a relationship between these treatments and circadian or sleep rhythms, but not the unqualified claim that all are successful depression treatments that directly affect circadian rhythms. (LLM, conf=0.88)
Experimental — accuracy not yet measured
The improvement in both groups can be explained by non-specific treatment effects such as the structure offered by the study, interaction with the researchers, or increased awareness and self-care resulting from participating in the study.
“Second, the improvement in both groups can be explained by non-specific treatment effects such the structure offered by the study,43 the interaction with the researchers or increased awareness and self-care resulting from participating in the study.”
From Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial (2020) · cites this paper as [43]
The 'Circadian hypotheses of depression' section links regular social rhythms with reduced depressive symptoms, and 'Chronotherapies for depression' describes therapy aimed at stabilizing routines. Neither passage addresses whether the structure of participating in a study could produce nonspecific improvement in both groups; the copy also does not address researcher interaction or increased self-care as explanations. (LLM, conf=0.72)
Experimental — accuracy not yet measured
Subsequent studies examining the role of the SCN in regulating depressive-like behavior have reached the opposite conclusion using animals with an intact SCN.
“subsequent studies examining the role of the SCN in regulating depressive-like behavior have reached the opposite conclusion utilizing animals with an intact SCN83,84.”
From Circadian rhythm disruption and mental health (2020) · cites this paper as [83]
The ‘Central and peripheral oscillators’ section describes how SCN lesions and transplants affect circadian rhythms, but does not report studies of depressive-like behavior in animals with an intact SCN. Searches for intact-SCN animal studies and depressive-like behavior found no passage addressing the claimed opposite conclusion; page numbers were unavailable in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measured
PMDD women experience a phase-advance of circadian rhythms similar to what is observed in MDD.
“Lending further support to the idea that PMDD women experience a phase-advance of circadian rhythms similar to what is observed in MDD [108], these women also experienced a tendency for phase-advanced CBT rhythms as well as significantly advanced melatonin and TSH when compared with controls (Table 2).”
From Sleep, hormones, and circadian rhythms throughout the menstrual cycle in healthy women and women with premenstrual dysphoric disorder (2010) · cites this paper as [108]
The relationships between depression and circadian rhythms in behavior and physiology are probably bidirectional.
“The relationships between depression and circadian rhythms in behavior and physiology are probably bidirectional”
From Digital Biomarkers for Depression Screening With Wearable Devices: Cross-sectional Study With Machine Learning Modeling (2021) · cites this paper as [64]

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Lund R Kammerloher A Dirlich G Wehr TA Goodwin FK 1983 Body temperature in endogenously depressed patients during depression and remission Circadian rhythms in psychiatry The Boxwood Press Pacific Grove, CA 77 88

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Authors: Germain, A., & Kupfer, D. J.
Affiliations: University of Pittsburgh (US)
Corresponding author: Germain, Anne
ORCID: Germain, Anne
Kupfer, David J.
Venue: Human Psychopharmacology: Clinical and Experimental
Publisher: Wiley
Published: 2008-08-05
Volume: 23
Issue: 7
Pages: 571-585
ISSN: 0885-6222 (ISSN-L)
1099-1077
DOI: 10.1002/hup.964
PMC: PMC2612129
OpenAlex: W2104247936
Cited by: 644
References: 222
Citations by year: 2026: 35 · 2025: 32 · 2024: 43 · 2023: 55 · 2022: 52 · 2021: 50 · 2020: 43 · 2019: 32 · 2018: 32 · 2017: 42 · 2016: 29 · 2015: 35 · 2014: 32 · 2013: 31 · 2012: 31
FWCI: 2.53
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Human Psychopharmacology Clinical and Experimental (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (R25MH060473)
Topics: Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords: circadian rhythm, depression, sleep disorders, chronotherapy, bright light therapy, sleep deprivation, seasonal affective disorder, antidepressants, chronobiology, mood disorders
MeSH terms: Depression, Humans, Chronobiology Disorders

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