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Effects of morning phototherapy on circadian markers in seasonal affective disorder

Published online by Cambridge University Press:  03 January 2018

C. Thompson*
Affiliation:
University of Southampton, Hampshire
P. A. Childs
Affiliation:
University of Southampton, Hampshire
N. J. Martin
Affiliation:
University of Southampton, Hampshire
I. Rodin
Affiliation:
University of Southampton, Hampshire
P. J. Smythe
Affiliation:
University of Southampton, Hampshire
*
Professor C. Thompson. University of Southampton, Department of Psychiatry, Royal South Hants Hospital, Graham Road. Southampton S09 4PE. Fax 01703 234243

Abstract

Background

The suppression of melatonin by light at 00.30 hours has been shown to be greater in winter than in summer in patients with seasonal affective disorder (SAD) but not in matched normal controls.

Method

In this study 12 patients with SAD and 12 matched normal controls were exposed to morning light therapy in the winter. Melatonin profiles and sensitivity to light were measured before and after treatment.

Results

The SAD but not the normal group showed a phase advance of melatonin rhythms in response to phototherapy. There was an association between phase position and phase shift in the SAD but not in the normal group.

Conclusions

There may be instability of circadian rhythms in SAD mediated by a high-amplitude phase response curve, rather than a fixed phase abnormality as had been previously suggested. This instability may be secondary to impaired serotoninergic function in the afferent pathways to the suprachiasmatic nuclei.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual for Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Bojkowski, C. J., Aldhous, M. E., English, J., et al (1987) Suppression of noctunal plasma melatonin and 6-sulphataxy-melatonin by bright and dim light in man. Hormone Metabolism Research, 19, 437440.Google Scholar
Cummings, M. A., Berga, S. L., Cummings, K. L., et al (1999) Light suppression of melatonin in unipolar depressed patients. Psychiatry Research, 27, 351355.Google Scholar
Czeisler, C., Kronauer, R. E., Mooney, J. J., et al (1987) Biological rhythm disorders, depression and phototherapy - a new hypothesis. Psychiatric Clinics of North America, 10, 687709.Google Scholar
Fraser, S., Cowen, P., Franklin, M., et al (1983) Direct radioimmunoassay for melatonin in plasma. Clinical Chemistry, 29, 396399.CrossRefGoogle ScholarPubMed
Lam, R.W., Gorman, C. P., Michalon, M., et al (1995) Multicentre placebo controlled study of fluoxetine in seasonal affective disorder. American Journal of Psychiatry, 152, 17651770.Google Scholar
Lam, R.W., Gorman, C. P., Michalon, M., Zis, A. P., Grewal, A., et al (1996) Effects of rapid tryptophan depletion in patients with seasonal affective disorder in remission after light therapy. Archives of General Psychiatry 53, 4144.CrossRefGoogle ScholarPubMed
Lewy, A. J., Wehr, T. A., Goodwin, F. K., et al (1980) Light suppresses melatonin secretion in humans. Science, 210, 12671269.Google Scholar
Lewy, A. J., Wehr, T. A., Goodwin, F. K., et al (1981) Manic depressive patients may be supersensitive to light. Lancet, i, 383384.Google Scholar
Lewy, A. J., Wehr, T. A., Goodwin, F. K., Nurnberger, J. L., Wehr, T. A., et al (1985) Supersensitivity to light: possible trait marker for manic depressive illness. American journal of Psychiatry, 142, 725727.Google Scholar
Lewy, A. J., Wehr, T. A., Goodwin, F. K., Sack, R. L., Singer, C. M., et al (1987) The phase shift hypothesis for bright light's therapeutic mechanism of action: theoretical considerations and experimental evidence. Psychopharmacology Bulletin, 23, 349353.Google Scholar
Mcintyre, I. M., Norman, T. R., Burrows, G. D., et al (1989a) Quantal melatonin suppression by exposure to low intensity light in man. life Sciences, 45, 327332.CrossRefGoogle ScholarPubMed
Mcintyre, I. M., Norman, T. R., Burrows, G. D., et al (1989b) Human melatonin response to light at different times of the night. Psychoneuroendocrinology, 14, 187193.CrossRefGoogle ScholarPubMed
O'Rourke, D A., Wurtman, J J., Brzexinsid, A., et al (1987) Serotonin implicated in etiology of seasonal affective disorder. Psychopharmacology Bulletin, 23, 358359.Google ScholarPubMed
Rosenthal, N. E., Sack, D A., Gillin, J. C., et al (1984) Seasonal affective disorder: a description of the syndrome and preliminary findings with light therapy. Archive of General Psychiatry 41, 7280.CrossRefGoogle ScholarPubMed
Rosenthal, N. E., Sack, D A., Gillin, J. C. & Wehr, T. A. (1992) Towards understanding the mechanism of action of light in seasonal affective disorder. Pharmacopsychiatry, 25, 5660.Google Scholar
Terman, M., Terman, J. S., Quitkin, F. M., et al (1989) Light therapy for seasonal affective disorder, a review of efficacy. Neuropsychophormacology 2, 122.Google Scholar
Thompson, C. (1985) Circadian rhythms in psychiatry. British Journal of Psychiatry 146, 557558.Google Scholar
Thompson, C., Stinson, D & Smith, A. (1990) Seasonal affective disorder and season-dependent abnormalities of melatonin secretion by light. Lancet, 336, 703706.Google Scholar
Williams, J. B. W., Link, M. J., Rossenthal, N.E., et al (1987) Structured Interview for the Hamilton Depression Rating Scale - Seasonal Affective Disorder Version (SIGHSAD). New York: New York State Psychiatric Institute.Google Scholar
Winton, F., Corn, T., Huson, L. W., et al (1989) Effects of light treatment upon mood and melatonin in patients with seasonal affective disorder. Psychological Medicine, 19, 585590.Google Scholar
Wirz-Justice, A., Krauchi, K., Graw;, P., et al (1994) Testing circadian rhythm hypotheses of winter depression in the constant routine protocol. Neuropsychopharmocology, 10, 868S.Google Scholar
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