주요우울증 환자에서 일주기 형태에 따른 양극성 경향, 자살 사고, 청각유발전위와의 관련성 : 예비 연구 = Chronotype in Relation to Bipolarity, Suicidal Ideation, and Auditory Evoked Potentials in Patients with Major Depressive Disorder : Preliminary Study

다국어 초록 (Multilingual Abstract)

Objectives The current study investigated the putative relationship between chronotype and suicidality or bipolarity in patients with major depressive disorder (MDD). Method Nineteen outpatients who met the criteria for MDD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision were recruited for the current study. The subjects were divided into two subgroups based on their Basic Language Morningness (BALM) scores (dichotomized according to the median BALM score). The Loudness Dependence of Auditory Evoked Potentials (LDAEP) was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. In addition, K-Mood Disorder Questionaire (K-MDQ), Beck Scale for Suicidal Ideation (BSS), Beck Hopelessness Scale (BHS), Barratt Impulsiveness Scale (BIS) were applied. Results The K-MDQ, BSS, BHS, BIS score was higher for the eveningness group than for the morningness group. However, the LDAEP, Hamilton Depression Rating Scale, Hamilton Anxiety Scale scores did not differ significantly between them. There were negative correlations between the total BALM score and the total K-MDQ, BSS, and BHS scores (r=-0.64 and p=0.0033, r=-0.61 and p=0.0055, and r=-0.72 and p=0.00056, respectively). Conclusions Depressed patients with eveningness are more vulnerable to the suicidality than those with morningness. Eveningness is also associated with bipolarity.

참고문헌 (Reference)

1 Hirschfeld RM, "Validity of the mood disorder questionnaire : a general population study" 160 : 178-180, 2003

2 Jon DI, "Validity and reliability of the Korean version of the Mood Disorder Questionnaire" 50 : 286-291, 2009

3 Kim DR, "The relationship between bipolar disorder, seasonality, and premenstrual symptoms" 13 : 500-503, 2011

4 Beck AT, "The measurement of pessimism : the hopelessness scale" 42 : 861-865, 1974

5 Park YM, "The loudness dependence of the auditory evoked potential(LDAEP)in schizophrenia, bipolar disorder, major depressive disorder, anxiety disorder, and healthy controls" 34 : 313-316, 2010

6 Park YM, "The loudness dependence of the auditory evoked potential(LDAEP)as a predictor of the response to escitalopram in patients with generalized anxiety disorder" 213 : 625-632, 2011

7 Kim DH, "The association between suicidality and serotonergic dysfunction in depressed patients" 148 : 72-76, 2013

8 Reid KJ, "Systematic evaluation of Axis-I DSM diagnoses in delayed sleep phase disorder and evening-type circadian preference" 13 : 1171-1177, 2012

9 Barclay NL, "Sleep quality and diurnal preference in a sample of young adults: associations with 5HTTLPR, PER3, and CLOCK 3111" 156 : 681-690, 2011

10 Monti JM, "Serotonin control of sleep-wake behavior" 15 : 269-281, 2011

11 Gudlowski Y, "Serotonergic dysfunction in the prodromal, first-episode and chronic course of schizophrenia as assessed by the loudness dependence of auditory evoked activity" 109 : 141-147, 2009

12 Miller CJ, "Sensitivity and specificity of the Mood Disorder Questionnaire for detecting bipolar disorder" 81 : 167-171, 2004

13 Abe T, "Relation between morningness-eveningness score and depressive symptoms among patients with delayed sleep phase syndrome" 12 : 680-684, 2011

14 Brown FM, "Psychometric equivalence of an improved Basic Language Morningness(BALM)scale using industrial population within comparisons" 36 : 191-197, 1993

15 Hegerl U, "Intensity dependence of auditory evoked potentials as an indicator of central serotonergic neurotransmission : a new hypothesis" 33 : 173-187, 1993

16 Manchia M, "Genetic risk of suicidal behavior in bipolar spectrum disorder : analysis of 737 pedigrees" 15 : 496-506, 2013

17 Patton JH, "Factor structure of the Barratt impulsiveness scale" 51 : 768-774, 1995

18 Merikanto I, "Evening types are prone to depression" 30 : 719-725, 2013

19 Cardoso de Almeida JR, "Distinguishing between unipolar depression and bipolar depression : current and future clinical and neuroimaging perspectives" 73 : 111-118, 2013

20 Manning JS, "Difficult-to-treat depressions: a primary care perspective" 64 (64): 24-31, 2003

21 Lee HJ, "Delayed sleep phase syndrome is related to seasonal affective disorder" 133 : 573-579, 2011

22 Robillard R, "Delayed sleep phase in young people with unipolar or bipolar affective disorders" 145 : 260-263, 2013

23 Ojeda DA, "Common functional polymorphisms in SLC6A4 and COMT genes are associated with circadian phenotypes in a South American sample" 35 : 41-47, 2014

24 Jae Kyung Chung, "Circadian Rhythm Characteristics in Mood Disorders: Comparison among Bipolar I Disorder, Bipolar II Disorder and Recurrent Major Depressive Disorder" 대한정신약물학회 10 (10): 110-116, 2012

25 Ahn YM, "Chronotype distribution in bipolar I disorder and schizophrenia in a Korean sample" 10 : 271-275, 2008

26 박영민, "Can the Loudness Dependence of Auditory Evoked Potentials and Suicidality Be Used to Differentiate between Depressive Patients with and without Bipolarity" 대한신경정신의학회 10 (10): 143-147, 2013

27 Juckel G, "Auditory-evoked potentials as indicator of brain serotonergic activity--first evidence in behaving cats" 41 : 1181-1195, 1997

28 Selvi Y, "Associations between chronotype, sleep quality, suicidality, and depressive symptoms in patients with major depression and healthy controls" 27 : 1813-1828, 2010

29 Choi J, "Association of seasonality and premenstrual symptoms in bipolar I and bipolar II disorders" 129 : 313-316, 2011

30 Park YM, "Association between BDNF gene polymorphisms and serotonergic activity using loudness dependence of auditory evoked potentials in healthy subjects" 8 : e60340-, 2013

31 Beck AT, "Assessment of suicidal intention : the Scale for Suicide Ideation" 47 : 343-352, 1979

32 Semlitsch HV, "A solution for reliable and valid reduction of ocular artifacts, applied to the P300 ERP" 23 : 695-703, 1986

33 Hamilton M, "A rating scale for depression" 23 : 56-62, 1960

34 Imeri L, "5-Hydroxytryptophan, but not L-tryptophan, alters sleep and brain temperature in rats" 95 : 445-452, 2000

35 Ghaemi SN, ""Cade’s disease"and beyond : misdiagnosis, antidepressant use, and a proposed definition for bipolar spectrum disorder" 47 : 125-134, 2002