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

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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

DOI 10.1016/j.neubiorev.2021.02.045

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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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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.
ORCID: Carpenter, Joanne S.
Crouse, Jacob J.
Scott, Elizabeth M.
Naismith, Sharon L.
Wilson, Chloe
Scott, Jan
Merikangas, Kathleen R.
Hickie, Ian B.
Venue: Neuroscience & Biobehavioral Reviews
Publisher: Elsevier BV
Published: 2021-07
Volume: 126
Pages: 79-101
ISSN: 0149-7634 (ISSN-L)
DOI: 10.1016/j.neubiorev.2021.02.045
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: green
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
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 (medical) › 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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Circadian depression: A mood disorder phenotype

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