Pineal volume and evening melatonin in young people with affective disorders
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Affective disorders in young people have been associated with disruptions in circadian rhythms, including abnormalities in secretion of the pineal hormone melatonin. Previous research reports relationships between pineal gland volumes, melatonin secretion, and sleep-wake cycles, but the relationship between these factors has not been explored in affective disorders. This study aimed to characterize these factors and explore associations with mood symptoms and functioning in a sample of young people with affective disorders. Pineal volume from magnetic resonance imaging and melatonin assay from evening dim-light saliva collection were evaluated in 50 individuals (15–30 years old; 72 % female) with bipolar, depressive, or anxiety disorders. Actigraphy monitoring was also conducted for approximately two weeks to derive sleep-wake measures. Pineal volume was associated with melatonin secretion across the evening, replicating previous findings in psychiatrically healthy individuals. Pineal volume was smaller in participants in which melatonin onset was not detected. Timing of melatonin secretion was related to sleep timing, but amount of melatonin and pineal volume were not related to any sleep-wake measures. A shorter phase angle between onset of melatonin secretion and sleep onset was associated with longer total sleep time. Lower melatonin levels were associated with poorer social and occupational functioning. Although pineal volume is not directly related to sleep disturbances or symptoms, melatonin may influence both sleep-wake cycles and functioning in the early stages of affective disorder. Causal links remain to be established, however, treatments that target circadian rhythms may be useful in improving functioning in young people with affective disorders.
KeywordsSleep Circadian Melatonin Pineal gland Affective disorders MRI
The authors wish to thank, Mr. Mark Salkeld and Professor David Kennaway for expertise with melatonin assays, and Mr. Bart te Lindert for assistance with Geneactiv actigraphy processing tools.
Compliance with ethical standards
Prof. Hickie was funded by a National Health and Medical Research Council Program Grant (No. 566,529) and Australian Fellowship (No. 464,914). Dr. Robillard received a postdoctoral training award from the Fonds de la recherche en santé du Québec.
Conflict of interest
Dr. Hermens has received honoraria for educational seminars from Janssen-Cilag and Eli Lilly. Prof. Hickie is the Co-Director, Health and Policy, of the Brain and Mind Centre, which operates two early-intervention youth services under contract to headspace. He is a member of the new Australian National Mental Health commission and was previously the CEO of beyondblue: the national depression initiative, and a director of headspace: the national youth mental health foundation. He has led a range of community-based and pharmaceutical industry-supported depression awareness and education and training programs. He has led depression and other mental health research projects that have been supported by a variety of pharmaceutical partners. Current investigator-initiated studies are supported by Servier and Pfizer. He has received honoraria for his contributions to professional educational seminars supported by the pharmaceutical industry (including Servier, Pfizer, AstraZeneca, and Eli Lilly). All other co-authors have no financial disclosure or conflict of interest to report.
The study was approved by the University of Sydney Human Research Ethics Committee and all participants gave written informed consent. All procedures performed were in accordance with the ethical standards of the institutional committee and the declaration of Helsinki (2013).
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