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Diurnal variation of mood and the cortisol rhythm in depression and normal states of mind

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Summary

A large scale chronobiological investigation was undertaken in 20 drug-free psychiatric inpatients displaying RDC major depression (endogenous subtype) in comparison to 10 healthy control subjects and 10 of the patients after clinical recovery. A series of measurements was taken 6 times a day and, in 8 of a total of 14 variables, also once a night over a period of 10 to 14 days. The following variables were assessed: mood (three different scales), performance (two tests), motor activity (three measures), salivary flow, urinary excretion of water, sodium, potassium, and free cortisol (UFC), and rectal temperature. A phase chart of the acrophases of the 8 variables with measurements taken during day and night revealed two clusters in the depressives and three in the non-depressed subjects. In the depressives, the acrophases of the mood scales clustered around the time of awakening in the morning, together with the acrophase of UFC, whereas all other acrophases clustered in the afternoon. In the non-depressed subjects, however, the mood scales reached their circadian maxima in the middle of the night around the time when sleep was interrupted to take measurements. All other acrophases corresponded roughly with those found in the depressives. The coincidence of the time course of depressed mood and cortisol excretion in the patients was interpreted as reflecting a temporal relationship between diurnal mood swings in depression and the cortisol rhythm. This interpretation was supported by the significant correlation between the acrophases of the two respective rhythms in patients showing a significant diurnal variation in mood. The mood curves of non-depressed subjects seemed unrelated to the cortisol rhythm. Probably, they mirror diurnal fluctuations of vigilance rather than fluctuations of mood. According to the literature, this rhythm is temporally related to the rhythm of melatonin secretion.

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References

  • Åkerstedt T, Fröberg JE, Friberg Y, Wetterberg L (1979) Melatonin excretion, body temperature and subjective arousal during 64 hours of sleep deprivation. Psychoneuro-endocrinology 4:219–225

    Google Scholar 

  • Åkerstedt T, Gillberg M, Wetterberg L (1982) The circadian covariation of fatigue and urinary melatonin. Biol Psychiatry 17:547–553

    Google Scholar 

  • American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders (3rd edn) (DSM-III). APA, Washington, DC

    Google Scholar 

  • Aschoff J (1979) Circadian rhythms: general features and endocrinological aspects. In: Krieger DT (ed) Endocrine rhythms. Raven Press, New York, pp 1–61

    Google Scholar 

  • Bjerner B, Holm A, Swensson A (1955) Diurnal variation in mental performance. Br J Int Med 12:103–110

    Google Scholar 

  • Carlsson A, Svennerholm L, Winblad B (1980) Seasonal and circadian monoamine variations in human brains examined post mortem. Acta Psychiatr Scand (Suppl) 280 ad vol 61:75–85

    Google Scholar 

  • Chitani H (1958) Manic-depressive psychoses. Byotai-Seirigaku-Taikei, VIII. Nakayama Shoten, Tokyo (Japanese; cit after Sakai 1960)

    Google Scholar 

  • Dirlich G, Barthelmes H, von Lindern L, Lund R, von Zerssen D (1987) A chronobiological study of depression: Discussion from a methodological perspective. In: Halaris A (ed) Chronobiology and neuropsychiatric disorders. Elsevier,New York Amsterdam London, pp 133–158

    Google Scholar 

  • Doerr P, von Zerssen D (1983) Die zirkadiane Ausscheidung an freiem Harncortisol während der depressiven Phase und im freien Intervall bei Patienten mit einer endogenen Depression. In: Faust V, Hole G (eds) Depressionen: Symptomatik-Ätiopathogenese-Therapie. Hippokrates, Stuttgart, pp 142–150

    Google Scholar 

  • Enright JT (1981) Data analysis. In: Aschoff J (ed) Handbook of behavioral neurobiology, vol 4. Plenum, New York London, pp 21–39

    Google Scholar 

  • Fink M (1979)Convulsive therapy: theory and practice. Raven Press, New York

    Google Scholar 

  • Freud S (1957) Mourning and melancholia. Hogarth Press, London (1st edn in German 1917)

    Google Scholar 

  • Fröberg JE (1977) Twenty-four-hour patterns in human performance, subjective and physiological variables and differences between morning and evening active subjects. Biol Psychol 5:119–134

    Google Scholar 

  • Grunhaus L, Flegel P, Carroll BJ, Greden JF (1985) Self-reported diurnal mood changes, early morning awakening and the dexamethasone suppression test in endogenous depression. J Affect Disord 8:1–7

    Google Scholar 

  • Halberg F (1968) Physiologic considerations underlying rhythmometry with special reference to emotional illness. In: de Ajuriaguerra J (ed) Cycles biologiques et psychiatrie.Georg, Geneve; Masson, Paris, pp 73–126

    Google Scholar 

  • Halbreich U, Asnis GM, Shindledecker R, Zumoff B, Nathan S (1985) Cortisol secretion in endogenous depression. Arch Gen Psychiatry 42:904–908

    Google Scholar 

  • Hiller W, von Zerssen D, Mombour W, Wittchen H-U (1986) IMPS (Inpatient Multidimensional Psychiatric Scale) (German version). Manual. Beltz Test, Weinheim

    Google Scholar 

  • Janowsky DL, El-Yousef MK, Davis JM (1972) A cholinergic-adrenergic hypothesis of mania and depression. Lancet II:632–635

    Google Scholar 

  • Jarrett DB, Coble PA, Kupfer DJ (1983) Reduced cortisol latency in depressive illness. Arch Gen Psychiatry 40:506–511

    Google Scholar 

  • Kawamura H, Inouye S-IT (1979) Circadian rhythm in a hypothalamic island containing the suprachiasmatic nucleus. In: Suda M, Hayaishi O, Nakagawa H (eds) Biological rhythms and their central mechanism. Elsevier Biomedical Press, Amsterdam New York Oxford, pp 335–341

    Google Scholar 

  • Köbberling J, von zur Mühlen A (1972) Methodische Untersuchungen zur Bestimmung der freien Harn-Corticoide mit der Proteinbindungsmethode. Z Klin Chem 10:495–501

    Google Scholar 

  • Krieger DT (1979) Rhythms in CRF, ACTH, and corticosteroids. In: Krieger DT (ed) Endocrine rhythms. Raven, New York, pp 123–142

    Google Scholar 

  • Kripke DF (1983) Phase-advance theories for affective illnesses. In: Wehr TA, Goodwin FK (eds) Circadian rhythms in psychiatry. Boxwood, Pacific Grove, pp 41–69

    Google Scholar 

  • Kripke DF, Mullaney DJ, Atkinson M, Wolf S (1978) Circadian rhythm disorders in manic-depressives.Biol Psychiatry 13:335–351

    Google Scholar 

  • Linkowski P, Mendlewicz J, Leclercq R, Brasseur M, Hubain P, Golstein J, Copinschi G, van Canter E (1985) The 24-hour profile of adrenocorticotropin and cortisol in major depressive illness. J Clin Endocrinol Metab 61:429–438

    Google Scholar 

  • Lobban M, Tredre B, Elithorn A, Bridges P (1963) Diurnal rhythms of electrolyte excretion in depressive illness. Nature 199:667–669

    Google Scholar 

  • Lorr M, Klett CJ (1967) Inpatient Multidimensional Psychiatric Scale (IMPS), revised. Consulting Psychologist Press, Palo Alto

    Google Scholar 

  • Lund R, Kammerloher A, Dirlich G (1983) Body temperature in endogenously depressed patients during depression and remission. In: Wehr TA, Goodwin FK (eds) Circadian Rhythms in Psychiatry. Boxwood Pacific Grove, pp 77–88

  • Lund R, Schulz H, Berger M (1985) Körpertemperatur und REM-Schlaf bei affektiven Störungen. In: Ferstl R, Rey E-R, Vaitl D (eds) Psychophysiologiscbe Merkmale klinischer Symptome, Band II. Beltz,Weinheim Basel, pp 48–69

    Google Scholar 

  • Luria RE (1975) The validity and reliability of the Visual Analogue Mood Scale. J Psychiatr REs 12:51–57

    Google Scholar 

  • Mellerup ET, Rafaelsen OJ (1979) Circadian rhythms in manic-melancholic disorders. In: Essman WB, Valzelli L (eds) Current Developments in Psychopharmacology. Spectrum Publications, New York London, pp 51–66

    Google Scholar 

  • Mendlewicz J (1984) Alterations in circadian secretion of pituitary and pineal hormones in affective disorders. In: Shah NS, Donald AG (eds) Psychoneuroendocrine Dysfunction. Plenum, New York London, pp 465–471

    Google Scholar 

  • Möller H-J, Barthelmes H, von Zerssen D (1983) Forschungsmöglichkeiten auf der Grundlage einer routinemäßig durchgeführten psychiatrischen Basis- und Befunddokumentation. Psychiatr Clin 16:45–61

    Google Scholar 

  • Moore RY (1979) The retinohypothalamic tract, suprachiasmatic hypothalamic nucleus and central neural mechanisms of circadian rhythm regulation. In: Suda M, Hayaishi O, Nakagawa H (eds) Biological rhythms and their central mechanisms. Elsevier Biomedical Press, Amsterdam New York Oxford, pp 342–354

    Google Scholar 

  • Otnes RK, Enochson L (1978) Applied time series analysis, vol 1. Wiley, New YorkChichester Brisbane Toronto

    Google Scholar 

  • Pirke KM, Stamm D (1970) Die Bestimmung von Natrium, Kalium und Calcium im Harn mit dem Filterflammen-photometer. Z Klin Chem 8:241–248

    Google Scholar 

  • Pflug B, Tölle R (1971) Disturbance of the 24 hour rhythm in endogenous depression and the treatment of endogenous depression by sleep deprivation. Int Pharmacopsychiatry 6:187

    Google Scholar 

  • Pflug B, Erikson R, Johnsson A (1976) Depression and daily temperature. A long-term study. Acta Psychiatr Scand 54:254–266

    Google Scholar 

  • Pflug B, Johnsson A, Martin W (1983) Alterations in the circadian temperature rhythms in depressed patients. In: Wehr TA, Goodwin FK (eds) Circadian rhythms in psychiatry. Boxwood, Pacific Grove, pp 71–76

    Google Scholar 

  • Rechtschaffen A, Kales A (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. US Department of Health, Education and Welfare, National Institute of Health, Washington, DC

    Google Scholar 

  • Reinberg A, Smolensky MH (1983) Biological rhythms and medicine. Cellular, metabolic, physiopathologic, and pharmacologic aspects. Springer, New York Berlin Heidelberg Tokyo

    Google Scholar 

  • Rusak B, Zucker I (1979) Neural regulation of circadian rhythms. Physiol Rev 59:449–526

    Google Scholar 

  • Sachar EJ, Hellman L, Roffwarg HP, Halpern FS, Fukushima DK, Gallagher TF (1973) Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Arch Gen Psychiatry 28:19–24

    Google Scholar 

  • Sakai M (1960) Diurnal rhythm of 17-ketosteroid and diurnal fluctuation of depressive affect. Yokohama Med Bull 11:352–367

    Google Scholar 

  • Schilgen B, Tölle R (1980) Partial sleep deprivation as therapy for depression. Arch Gen Psychiatry 37:267–271

    Google Scholar 

  • Schulz H, Lund R (1985) On the origin of early REM episodes in the sleep of depressed patients. Comparison of three hypotheses. Psychiatry Res 16:65–77

    Google Scholar 

  • Schwartz WJ, Smith CB, Davidsen LC (1979) In vivo glucose utilization of the suprachiasmatic nucleus. In: Suda M, Hayaishi O, Nakagawa H (eds) Biological rhythms and their central mechanism. Elsevier Biomedical Press, Amsterdam New York Oxford, pp 355–367

    Google Scholar 

  • Sherman BM, Pfohl B (1985) Rhythm-related changes in pituitary-adrenal function in depression. J Affect Disord 9:55–61

    Google Scholar 

  • Siegel S (1956) Nonparametric statistics for the behavioral sciences. McGraw-Hill New York; Kogakusha Tokyo

    Google Scholar 

  • Spitzer RL, Endicott JE, Robins E (1977) Research diagnostic criteria for a selected group of functional disorders, 3rd edn. New York State Psychiatric Insitute, Biometric Research, New York

    Google Scholar 

  • Takuma T (1959) Hämatoporphyrinbehandlung der depressiven Zustände. (Japanese; cit after Sakai 1960) Clin Psychol 1:325

    Google Scholar 

  • Wehr TA, Goodwin FK (1981) Biological rhythms and psychiatry. In: Arieti S (ed) American handbook of psychiatry, advances and new directions, 2nd edn. Basic Books, New York, pp 46–74

    Google Scholar 

  • Wehr TA, Goodwin FK (1983a) Circadian rhythms in psychiatry. Boxwood, Pacific Grove

    Google Scholar 

  • Wehr TA, Goodwin FK (1983b) Biological rhythms in manic-depressive illness. In: Wehr TA, Goodwin FK (eds) Circadian rhythms in psychiatry. Boxwood, Pacific Grove, pp 129–184

    Google Scholar 

  • Wehr TA, Sack DA, Duncan WC, Mendelson WB, Rosenthal NE, Gillin JC, Goodwin FK (1985) Sleep and circadian rhythms in affective patients isolated from external time cues. Psychiatry Res 15:327–339

    Google Scholar 

  • Wetterberg L, Halberg F, Tarquini B, Cagnoni M, Haus E, Griffith K, Kawasaki T, Wallach L-A, Ueno M, Ueno K, Matsouka M, Kuzel M, Halberg E, Omae T (1979) Circadian variation in urinary melatonin in clinically healthy women in Japan and the United States of America. Experientia 35:416–419

    Google Scholar 

  • Wever RA (1979) The circadian system of man. Results of experiments under temporal isolation. Springer, New York Heidelberg Berlin

    Google Scholar 

  • Yamaguchi N, Maeda K, Kuromaru S (1978) The effects of sleep deprivation on the circadian rhythm of plasma cortisol levels in depressive patients. Folia Psychiatr Neurol Jpn 32:479–487

    Google Scholar 

  • Zerssen D von (1976) Klinische Selbstbeurteilungs-Skalen aus dem Münchener Psychiatrischen Informations-System (PSYCHIS München). Manuale: a) Allgemeiner Teil b) Die Beschwerden-Liste c) Paranoid-Depressivitäts-Skala, Depressivitäts-Skala d) Die Befindlichkeits-Skala. Beltz Test, Weinheim

    Google Scholar 

  • Zerssen D von (1983) Chronobiology of depression. In: Angst J (ed) The origins of depression: Current concepts of approaches. Dahlem Konferenzen. Springer, Berlin Heidelberg New York Tokyo, pp 253–271

    Google Scholar 

  • Zerssen D von (1985) Psychiatric syndromes from a clinical and a biostatistical point of view. Psychopathology 18:88–97

    Google Scholar 

  • Zerssen D von (1986) Clinical self-rating scales (CSRS) of the Munich psychiatric information system (PSYCHIS München). In: Sartorius N, Ban TA (eds) Assessment of depression. Springer, Berlin Heidelberg New York Tokyo, pp 270–303

    Google Scholar 

  • Zerssen D von (1987) What is wrong with circadian clocks in depression? In: Halaris A (ed) Chronobiology and neuropsychiatric disorders. Elsevier, New York Amsterdam London, pp 159–179

    Google Scholar 

  • Zerssen D von, Cording C (1978) The measurement of change in endogenous affective disorders. Arch Psychiatr Nervenkr 226:95–112

    Google Scholar 

  • Zerssen D von, Berger M, Doerr P (1984) Neuroendocrine dysfunction in subtypes of depression. In: Shah NS, Donald AG (eds) Psychoneuroendocrine dysfunction. Plenum, New York London, pp 357–382

    Google Scholar 

  • Zerssen D von, Barthelmes H, Dirlich G, Doerr P, Emrich HM, von Lindern L, Lund R, Pirke KM (1985a) Circadian rhythms in endogenous depression. Psychiatry Res 16:51–63

    Google Scholar 

  • Zerssen D von, Dirlich G, Doerr P, Emrich HM, Lund R, Ploog D (1985b) Are biological rhythms disturbed in depression? Acta Psychiatr Belg 85:624–635

    Google Scholar 

  • Zerssen D von, Dirlich G, Zulley J (in press) Circadian rhythm disturbances in affective disorders — facts and fictions. In: Lerer B, Gershon S (eds) New directions in affective disorders. Springer, New York (in press)

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von Zerssen, D., Doerr, P., Emrich, H.M. et al. Diurnal variation of mood and the cortisol rhythm in depression and normal states of mind. Eur Arch Psychiatr Neurol Sci 237, 36–45 (1987). https://doi.org/10.1007/BF00385665

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