Special Issue for CURRENT PSYCHIATRY REVIEWS

Guest Editor: Maria Antonia Quera-Salva

Tentative Outline

SLEEP DISORDERS AND PSYCHIATRY

Aims & Scope:
Major depressive disorder (MDD) is a frequent disorder that poses a major handicap to patients. Disturbances of the sleep-wake pattern constitute one of the major complaints of patients with Major Depressive Disorder (MDD). Insomnia is not a simply a symptom of depression but may be an independent risk factor for both depression itself and the development of a new MDD episode or relapse. Understanding MDD is essential in order not only to treat acute episodes, but also to prevent recurrence. Several disorders are closely linked to MDD, and it is probable that several subtypes of MDD exist. Bipolar disorder is sometimes hard to distinguish from MDD due to infrequent episodes of elevated mood, and seasonal depression may rest undiagnosed as neither patients nor physicians have linked the onset of recurrence to changes in day length. Links between depression sleep and circadian rhythms have long been suspected due to the existence of seasonal depression, where the onset of low mood correlates with a reduction in day length and chaotic sleep wake cycles in patients suffering from bipolar disorder, where degradation in regular rhythms is associated with worsening of functional status and relapse of symptoms. Recent psychological and pharmacological treatments developed for depression target circadian rhythms and have been shown to be effective. Manipulation of circadian rhythms either using physical treatments (such as high intensity light) or behavioral therapy has shown promise in improving symptoms. Other psychiatric and developmental disorders also show abnormal circadian rhythms. Lack of external synchronizers can lead to free-running rhythms in patients with schizophrenia, while abnormal melatonin synthesis in certain congenital and acquired neurological disorders can lead to severely disordered sleep-wake cycles. Disordered circadian rhythms have also been implicated in some aspects of attention deficit and hyperactivity disorder. Pharmacotherapy using melatonin and pure melatonin receptor agonists, while improving sleep, have not been shown to improve symptoms of depression in the absence of an underlying circadian disorder but studies are small. Novel antidepressant combining 5HT2c antagonist and melatonin agonist action and chroniobiotic action has shown promise in both acute treatment of unipolar MDD and in preventing relapse. In conclusion, sleep and circadian rhythms are closely linked with depression.The Hot topic will review the available literature on the link between sleep, circadian rhythms and depression. Firstly Pr Maurice Oahyon will treat the epidemiology of sleep disorders in depression as insomnia is and independent risk factor for MDD, Pr Dieter Riemann will treat the link between insomnia, depression and relapse, Pr Marion Leboyer will treat the link between bipolar disorders, chaotic sleep wake cycles and behaviour therapy. Pr Alfred Lewy will treat the link between seasonal affective disorder and circadian rhythms, and Dr Quera Salva will develop the implication of circadian rhythms on unipolar major depression and the development of new antidepressant treatments targeting circadian rhythms.

Key words:
Depression, Dleep, Circadian rhythms , Disorder, Psychiatry

Subtopics:
Epidemiology Link between depression, insomnia and relapse Chaotic sleep wake cycles and behaviour therapy in bipolar disorders Seasonal affective disorder and circadian rhythms Circadian rhythms and treatments targeting circadian rhythm in unipolar depression

Schedule:
Manuscript submission deadline: Peer Review Due: Revision Due: Notification of acceptance by the Guest Editor: Final manuscripts due: April 2012 June 2012 August 2012 October 2012 October 2012