.. Circadian alignment appears to cause at most about 35% to 65% of the variance In symptom severity In SAD. The PSH may also be applied to sleep and other psychiatric disorders.

The PSH for these other disorders suggests that they are caused at least in part by a phase shift in circadian rhythms as marked by the DLMO with respect to the sleep/wake cycle. Inhibitors,research,lifescience,medical While we regard the PSH confirmed in SAD, the PSH remains to be tested in other sleep and psychiatric disorders. In our recent study,20 we reported that the weekly SIGHSAD ratings continuously declined over the 4 weeks of the study only in the correctly treated group. These are plotted in the figure along with those of the incorrectly treated group combined with the placebo group; the slopes (not shown) are significantly different (Figure 9). The treatment response appears to be clinically relevant, if not statistically significant, at weeks 1and 2. Patients who can sense Selleckchem APO866 improvement soon after beginning treatment are more Inhibitors,research,lifescience,medical likely to comply and continue until the maximum benefit is achieved. This is a serious problem with antidepressants, along with their accompanying side Inhibitors,research,lifescience,medical effects. Figure 9. Previously unpublished analyses based on data from the study by Lewy et al, 2006.20 SIGH-SAD and HAM-D scores of the groups receiving melatonin treatment given at the

correct time vs. the incorrect time or placebo are shown by week. Although a two-sample … Using the correlation Inhibitors,research,lifescience,medical with phase angle difference (PAD) to refine symptom assessment We are in the process of analyzing the data for the purpose of determining which of the 29 items of SIGHSAD account for the statistically significant findings for all of the main analyses of our recent study20 Unexpectedly, the group of eight additional SAD items was not statistically Inhibitors,research,lifescience,medical significant when used instead of the 294tem scale. This suggests that nonseasonal major depressive disorder, as measured by the 21-item HAM-D, might have a substantial circadian component related to the PSH. Furthermore, we have found

that all of the main analyses using just three items substituted for the entire scale (that has a tenfold greater range) results in almost identical because findings. These three items on 1-5 scales were: (1) self -reported symptoms of depression; (ii) self -reported symptoms of anxiety; and (iii) objective assessment of agitation of the subject by the rater at the time of the interview. Thus, anxiety disorders and mixed depressive/anxiety disorders should be evaluated for the PSH. Since depression and anxiety are frequently a part of sleep disorders, sleep disorders should also be tested for the PSH, as well as substance abuse disorders. As these iterative analyses proceed, we might be able to define a circadian endophenotype. However, we hesitate to use this term, as the range in PAD in healthy controls is the same as in our SAD patients, and the means are not much different.