Circadian rhythms in depression. Part II: Circadian rhythms in inpatients with various mental disorders

We investigated longitudinally the circadian body temperature rhythms in 65 inpatients with various mental disorders, 38 of whom had major depressive episodes, by estimating the deep body temperature from the skin surface every 2 h for a consecutive 48-h period. To estimate the circadian rhythm, the data obtained were analyzed by the least-squares method and maximum entropy spectral analysis (MEM). Circadian rhythm disturbances in patients with depression were likely to be manifested in phase variability rather than in phase advance. The amplitude of body temperature of the depressed group was significantly less than that of the control group. A positive correlation between the mesor and the severity of the depressive symptoms was found. Moreover, the body temperature of the patients with affective disorders, both in the depressive and in the manic state, tended to fluctuate so much as not only to fit poorly to sinusoid curves, but also to reduce the periodicity of the circadian rhythm. On the basis of these findings, we conclude that the essential feature of the rhythm disturbances in affective disorders is not the phase shift but the instability of the circadian temperature rhythm.