Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2015-0053
Trends in Psychiatry and Psychotherapy
Original Article

Activity/rest rhythm of depressed adolescents undergoing therapy: case studies

Ritmo de atividade e repouso em adolescentes deprimidos durante terapia: estudos de caso

Maria Eugênia Mesquita; Maria Eliza Finazzi; Bruno Gonçalves; Lee Fu-I; Leandro L. Duarte; José Ricardo Lopes; José Alberto Del-Porto; Luiz Menna-Barreto

http://dx.doi.org/10.1590/2237-6089-2015-0053 Trends Psychiatry Psychother, vol.38, n4, p.216-220, 2016
PDF
SciELO
Downloads: 0
Views: 590

Abstract

Abstract Introduction: Disorders of circadian rhythms have been reported in studies of both depressed children and of depressed adolescents. The aim of this study was to evaluate whether there is a relationship between the 24-hour spectral power (24h SP) of the activity/rest rhythm and the clinical course of depression in adolescents. Methods: Six 14 to 17-year-old adolescents were recruited for the study. They were all suffering from major depressive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria, as identified by the Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version (K-SADS-PL). Depressive symptoms were assessed using the Children's Depression Rating Scale - Revised (CDRS-R) and clinical evaluations. Locomotor activity was monitored over a period of 13 consecutive weeks. Activity was measured for 10-minute periods using wrist-worn activity monitors. All patients were prescribed sertraline from after the first week up until the end of the study. Results: We found a relationship between high CDRS values and low 24-hour spectral power. Conclusions: The 24h SP of the activity/rest rhythm correlated significantly (negatively) with the clinical ratings of depression.

Keywords

Circadian rhythms, chronobiology, spectral analysis, depression, adolescents

Resumo

Resumo Introdução: Distúrbios do ritmo circadiano têm sido relatados em estudos com crianças e adolescentes deprimidos. O objetivo deste estudo foi avaliar se existe relação entre a potência espectral de 24 horas do ritmo de atividade e repouso e sintomas clínicos de depressão em adolescentes. Métodos: Seis adolescentes com idade entre 14 e 17 anos foram recrutados para o estudo. Eles foram diagnosticados com depressão maior de acordo com os critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, 4ª edição (DSM-IV), identificados utilizando-se o instrumento Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version (K-SADS-PL). Os sintomas depressivos foram avaliados pelo questionário Children's Depression Rating Scale - Revised (CDRS-R) e por avaliações clínicas. A atividade motora foi monitorada por um período de 13 semanas consecutivas e registrada a cada 10 minutos utilizando-se monitores de atividades usados no pulso. Todos os pacientes utilizaram o antidepressivo sertralina começando após a primeira semana até o final do estudo. Resultados: Foi observada uma relação entre escores altos no CDRS-R e valores baixos de potência espectral de 24 horas no ritmo de atividade e repouso. Conclusão: A potência espectral de 24 horas do ritmo de atividade e repouso apresentou uma correlação significativa (negativa) com os sintomas clínicos de depressão.

Palavras-chave

Ritmos circadianos, cronobiologia, análise de potência espectral, depressão, adolescentes

References

Wehr TA, Goodwin FK, Wehr TA, Goodwin FK. Biological rhythms in manic-depressive illness. 1983:129-84.

Akiskal HS, Kaplan I, Sadock BJ. Transtornos do humor: introdução e panorama. 1999:1175-87.

Yanielli PC, Golombeck D. Cronobiología de la ansiedad e de la depresión mayor. 2002:171-86.

Brown LF, 3rd Reynolds CF, Monk TH, Prigerson HG, Dew MA, Houck PR. Social rhythm stability following late-life spousal bereavement: associations with depression and sleep impairment. Psychiatry Res. 1996;62:161-9.

Prigerson HG, 3rd Reynolds CF, Frank E, Kupfer DJ, George CJ, Houck PR. Stressful life events, social rhythms, and depressive symptoms among the elderly: an examination of hypothesized causal linkages. Psychiatry Res. 1994;51:33-49.

Szuba MP, Yager A, Guze BH, Allen EM, Baxter Jr LR. Disruption of social circadian rhythms in major depression: a preliminary report. Psychiatry Res. 1992;42:221-30.

Luik AI, Zuurbier LA, Direk N, Hofman A, Van Someren EJ, Tiemeier H. 24-hour activity rhythm and sleep disturbances in depression and anxiety: a population-based study of middle-aged and older persons. Depress Anxiety. 2015;32:684-92.

Wirz-Justice A, Bromundt V, Cajochen C. Circadian disruption and psychiatric disorders: the importance of entrainment. Sleep Med Clin. 2009;4:273-84.

Souêtre E, Salvati E, Belegou JL, Pringuey D, Candito M, Krebs B. Circadian rhythms in depression and recovery: evidence for blunted amplitude as the main chronobiological abnormality. Psychiatry Res. 1989;28:263-78.

Ávila Moraes C, Cambras T, Diez-Noguera A, Schimitt R, Dantas G, Levandovski R. A new chronobiological approach to discriminate between acute and chronic depression using peripheral temperature, rest-activity, and light exposure parameters. BMC Psychiatry. 2013;13:77.

Luik AI, Zuurbier LA, Hofman A, Van Someren EJ, Tiemeier H. Stability and fragmentation of the activity rhythm across the sleep-wake cycle: the importance of age, lifestyle, and mental health. Chronobiol Int. 2013;30:1223-30.

Hickie IB, Naismith SL, Robillard R, Scott EM, Hermens DF. Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression. BMC Med. 2013;11:79.

Goodwin FK and Jamison KR, Goodwin FK, Jamison KR. Childhood and adolescence. 1990:186-209.

McCauley E, Pavlidis K, Kendall K, Goodyer IM. Developmental precursors of depression: the child and the social environment. 2001:204-32.

de Souza CM, Hidalgo MP. Midpoint of sleep on school days is associated with depression among adolescents. Chronobiol Int. 2014;31:199-205.

Carissimi A, Dresch F, Martins AC, Levandovski RM, Adan A, Natale V. The influence of school time on sleep patterns of children and adolescents. Sleep Med. 2016;19:33-9.

Siever LJ, Davis KL. Overview: toward a dysregulation hypothesis of depression. Am J Psychiatry. 1985;142:1017-31.

Schulz H, Lund R. On the origin of early REM episodes in the sleep of depressed patients: a comparison of three hypotheses. Psychiatry Res. 1985;16:65-77.

Sokolove PG, Bushell WN. The chi square periodogram: its utility for analysis of circadian rhythms. J Theor Biol. 1978;72:131-60.

Teicher MH, Glod CA, Harper D, Magnus E, Brasher C, Wren F. Locomotor activity in depressed children and adolescents: I. Circadian dysregulation. J Am Acad Child Adolesc Psychiatry. 1993;32:760-9.

Gwirtsman HE, Halaris AE, Wolf AW, DeMet E, Piletz JE, Marler M. Apparent phase advance in diurnal MHPG rhythm in depression. Am J Psychiatry. 1989;146:1427-33.

Kupfer DJ, Weiss BL, Foster G, Detre TP, McPartland R. Psychomotor activity in affective states. Arch Gen Psychiatry. 1974;30:765-8.

Benoit O, Royant-Parola S, Borbely AA, Tobler I, Windlocher D. Circadian aspects of motor activity in depressed patients. Acta Psychiat Belg. 1985;85:582-92.

Raoux N, Benoit O, Dantchev N, Denise P, Franc B, Allilaire JF. Circadian pattern of motor activity in major depressive patients undergoing antidepressant therapy: relationship between actigraphic measures and clinical course. Psychiatry Res. 1994;52:85-98.

Dahl R, Puig-Antich J, Ryan N, Nelson B, Novacenko H, Twomey J. Cortisol secretion in adolescents with major depressive disorder. Acta Psychiatr Scand. 1989;80:18-26.

Puig-Antich J, Meltzer HY. Affective disorders in children and adolescents: diagnostic validity and psychobiology. 1987:843.

Dahl R, Ryan ND, Puig-Antich J, Nguyen NA, al-Shabbout M, Meyer VA. 24-hour cortisol measures in adolescents with major depression: a controlled study. Biol Psychiatry. 1991;30:25-36.

Cavallo A, Holt KG, Jejazi MS, Richards GE, Meyer WJ 3rd. Melatonin circadian rhythm in childhood depression. J Am Acad Child Adolesc Psychiatry. 1987;26:395-9.

Aronen ET, Teicher MH, Geenens D, Curtin S, Glod CA, Pahlavan K. Motor activity and severity of depression in hospitalized prepubertal children. J Am Acad Child Adolesc Psychiatry. 1996;35:752-63.

El Temps: the chronobiologist's program. 1999.

Fisher FM. Método de avaliação do ritmo de trabalho e repouso entre condutores de veículos. 1985.

Poznanski EO, Mokros HB. Children's Depression Ranting Scale, Revised (CDRS-R). 1996.

Teicher MH, Glod CA, Pahlavan K, Magnus E, Harper D. Circadian activity dysregulation and antidepressant response in children and adolescents. 1990;VI:58.

Godfrey HP, Knight RG. The validity of actometer and activity speech measures in the assessment of depressed patients. Br J Psychiatry. 1984;145:159-63.

Insel T, Cuthbert B, Garvey M, Heinssen R, Pine DS, Quinn K. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010;167:748-51.

6169eba1a953955f816b1ca2 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections