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BMC Medicine
Published in: BMC Medicine 1/2013

Open Access 01-12-2013 | Opinion

Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression

Authors: Ian B Hickie, Sharon L Naismith, Rébecca Robillard, Elizabeth M Scott, Daniel F Hermens

Published in: BMC Medicine | Issue 1/2013

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Abstract

Background

Clinical psychiatry has always been limited by the lack of objective tests to substantiate diagnoses and a lack of specific treatments that target underlying pathophysiology. One area in which these twin failures has been most frustrating is major depression. Due to very considerable progress in the basic and clinical neurosciences of sleep-wake cycles and underlying circadian systems this situation is now rapidly changing.

Discussion

The development of specific behavioral or pharmacological strategies that target these basic regulatory systems is driving renewed clinical interest. Here, we explore the extent to which objective tests of sleep-wake cycles and circadian function - namely, those that measure timing or synchrony of circadian-dependent physiology as well as daytime activity and nighttime sleep patterns - can be used to identify a sub-class of patients with major depression who have disturbed circadian profiles.

Summary

Once this unique pathophysiology is characterized, a highly personalized treatment plan can be proposed and monitored. New treatments will now be designed and old treatments re-evaluated on the basis of their effects on objective measures of sleep-wake cycles, circadian rhythms and related metabolic systems.
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Metadata
Title
Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression
Authors
Ian B Hickie
Sharon L Naismith
Rébecca Robillard
Elizabeth M Scott
Daniel F Hermens
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2013
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-11-79

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