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Tentative OutlineSpecial Issue for CURRENT PSYCHIATRY REVIEWS

Guest Editor: Maria Antonia Quera-SalvaSLEEP DISORDERS AND PSYCHIATRY

Aims & Scope:

Major depressive disorder (MDD) is a frequent disorder that poses a major handicap to patients. Disturbances of thesleep-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 degradationin 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) orbehavioral 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 andin 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 forMDD, 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 targetingcircadian 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 depressionSchedule:Manuscript submission deadline: April 2012

Peer Review Due: June 2012

Revision Due: August 2012

Notification of acceptance by the Guest Editor: October 2012

Final manuscripts due: October 2012