103
Zur Tagesschwankung der Depressionssymptomatik R. Tölle Klinik und Poliklinik für Psychiatrie der WestfaIischen Wilhelms-Universität Münster
Zusammenfassung
New symptom-statistical, chronobiological and experimental investigations concerning diurnal variation in endogenous depression (melancholia) are reported and interpreted referring to psychopathologieal, biological and phenomenological aspects.
Neuere symptomstatistischc, chronobiologisehe und experimentelle Untersuchungen zur Tagesschwankung bei Melancholie (endogener Depression) werden referiert und unter psychopathologischen, biologisch-psychiatrischen und phänomenologischen Aspekten interpretiert.
According to recent studies, the so-calied typical diurnal variation of mood (with morning low) is not as frequent, as it was assumed before, and even intraindividually unstable. Although more frequent than other daily rhythmus, the so called typical diurnal variation should not be used for diagnostic purposes, becausc it is quite frequent in different depressivc statcs as weil.
Die sog. typische Tagesschwankung (mit Morgentief) ist nach jüngeren exakten Untersuchungen bei weitem nicht so häufig, wie früher angenommen wurde und auch beim einzelnen Patienten instabil. Auch wenn sie die relativ häufigste Form der depressiven Tagesrhythmik ist, kann sie zur Diagnostik und Differentialdiagnostik kaum herangezogen werden; denn eine Tagesschwankung mit Morgentiefist auch bei anderen Depressionszuständen nicht selten.
During their healthy intervals endogenous depressive patients show not rarely an analogous diurnal variation of mood; this was also found in healthy subjects. Therefore the so called typical variation in mood is not specific, and it is questionable whether it is a marker of endogenous depression at all. Concerning circadian rhythm biological functions were examined more often than the depressive symptomatology itself (especially temperature, heart rate, cortisol and other neuroendocrine parameters). Unexpectedly there were only slight variations of the circadian diurnal curves in melancholie patients compared to healthy subjects. The circadian rhythm in endogenous depression does not seem to be very different from the physiological diurnal course. Comparing the biological circadian curves in endogenous depression to the curves of the depression symptomatology, the similaritics outline thc differences. Sleep research didn't show any results, supporting the suggestion of a specific rhythm variation eithcr. Thcreforc the opinion, that the circadian rhythm is altered basically in melancholia, cannot be maintained, neither psychopathologically nor biologically. Experiments oftime estimation in the course ofthe day could'nt explain the diurnal variation in mood either.
FortsehT. Neuro!. Psychiat. 59 (1991) 103 - [ 16
Zur Tagesschwankung der Depressionssymptomatik R. Tölle Klinik und Poliklinik für Psychiatrie der WestfaIischen Wilhelms-Universität Münster
Zusammenfassung
New symptom-statistical, chronobiological and experimental investigations concerning diurnal variation in endogenous depression (melancholia) are reported and interpreted referring to psychopathologieal, biological and phenomenological aspects.
Neuere symptomstatistischc, chronobiologisehe und experimentelle Untersuchungen zur Tagesschwankung bei Melancholie (endogener Depression) werden referiert und unter psychopathologischen, biologisch-psychiatrischen und phänomenologischen Aspekten interpretiert.
According to recent studies, the so-calied typical diurnal variation of mood (with morning low) is not as frequent, as it was assumed before, and even intraindividually unstable. Although more frequent than other daily rhythmus, the so called typical diurnal variation should not be used for diagnostic purposes, becausc it is quite frequent in different depressivc statcs as weil.
Die sog. typische Tagesschwankung (mit Morgentief) ist nach jüngeren exakten Untersuchungen bei weitem nicht so häufig, wie früher angenommen wurde und auch beim einzelnen Patienten instabil. Auch wenn sie die relativ häufigste Form der depressiven Tagesrhythmik ist, kann sie zur Diagnostik und Differentialdiagnostik kaum herangezogen werden; denn eine Tagesschwankung mit Morgentiefist auch bei anderen Depressionszuständen nicht selten.
During their healthy intervals endogenous depressive patients show not rarely an analogous diurnal variation of mood; this was also found in healthy subjects. Therefore the so called typical variation in mood is not specific, and it is questionable whether it is a marker of endogenous depression at all. Concerning circadian rhythm biological functions were examined more often than the depressive symptomatology itself (especially temperature, heart rate, cortisol and other neuroendocrine parameters). Unexpectedly there were only slight variations of the circadian diurnal curves in melancholie patients compared to healthy subjects. The circadian rhythm in endogenous depression does not seem to be very different from the physiological diurnal course. Comparing the biological circadian curves in endogenous depression to the curves of the depression symptomatology, the similaritics outline thc differences. Sleep research didn't show any results, supporting the suggestion of a specific rhythm variation eithcr. Thcreforc the opinion, that the circadian rhythm is altered basically in melancholia, cannot be maintained, neither psychopathologically nor biologically. Experiments oftime estimation in the course ofthe day could'nt explain the diurnal variation in mood either.
FortsehT. Neuro!. Psychiat. 59 (1991) 103 - [ 16
