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Lookup NU author(s): Emeritus Professor Jan Scott
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© 2021Major 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.
Author(s): Carpenter JS, Crouse JJ, Scott EM, Naismith SL, Wilson C, Scott J, Merikangas KR, Hickie IB
Publication type: Review
Publication status: Published
Journal: Neuroscience and Biobehavioral Reviews
Year: 2021
Volume: 126
Pages: 79-101
Print publication date: 01/07/2021
Online publication date: 06/03/2021
Acceptance date: 28/02/2021
ISSN (print): 0149-7634
ISSN (electronic): 1873-7528
Publisher: Elsevier Ltd
URL: https://doi.org/10.1016/j.neubiorev.2021.02.045
DOI: 10.1016/j.neubiorev.2021.02.045
PubMed id: 33689801
