Cited by 114Circadian rhythm and melatoninSleep and related disordersTreatment of Major Depression

Circadian depression: A mood disorder phenotype

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Carpenter, Joanne S., Crouse, Jacob J., Scott, Elizabeth M., Naismith, Sharon L., Wilson, Chloe, Scott, Jan, Merikangas, Kathleen R., Hickie, Ian B.·2021·Neuroscience & Biobehavioral Reviews

Abstract

Major mood syndromes are among the most common and disabling mental disorders. However, a lack of clear delineation of their underlying pathophysiological mechanisms is a major barrier to prevention and optimised treatments. Dysfunction of the 24-h circadian system is a candidate mechanism that has genetic, behavioural, and neurobiological links to mood syndromes. Here, we outline evidence for a new clinical phenotype, which we have called 'circadian depression'. We propose that key clinical characteristics of circadian depression include disrupted 24-h sleep-wake cycles, reduced motor activity, low subjective energy, and weight gain. The illness course includes early age-of-onset, phenomena suggestive of bipolarity (defined by bidirectional associations between objective motor and subjective energy/mood states), poor response to conventional antidepressant medications, and concurrent cardiometabolic and inflammatory disturbances. Identifying this phenotype could be clinically valuable, as circadian-targeted strategies show promise for reducing depressive symptoms and stabilising illness course. Further investigation of underlying circadian disturbances in mood syndromes is needed to evaluate the clinical utility of this phenotype and guide the optimal use of circadian-targeted interventions.

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Crossref · 10.1016/j.neubiorev.2021.02.045

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Authors
Carpenter, J. S., Crouse, J. J., Scott, E. M., Naismith, S. L., Wilson, C., Scott, J., Merikangas, K. R., & Hickie, I. B.
Affiliations
  • The University of Sydney (AU)
  • National Institute of Mental Health (US)
Corresponding author
Hickie, Ian B.
Venue
Neuroscience & Biobehavioral Reviews
Publisher
Elsevier BV
Published
2021-07
Volume
126
Pages
79-101
ISSN
0149-7634 (ISSN-L)
OpenAlex
W3135465928
Cited by
114
References
403
Citations by year
2026: 20 · 2025: 25 · 2024: 27 · 2023: 17 · 2022: 14 · 2021: 11
FWCI
2.21
Type
journal article
Language
en
Open access
Locations
  • Neuroscience & Biobehavioral Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • National Institutes of Health
  • National Institute of Mental Health (Z01MH002804)
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 disruption, mood disorders, sleep-wake cycle, motor activity, weight gain, bipolarity, antidepressant resistance, inflammation
MeSH terms
Bipolar Disorder, Circadian Rhythm, Depression, Humans, Phenotype, Sleep, Mood Disorders

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