대한수면의학회

Object: Diurnal variation is included in the diagnostic criteria of the major depressive disorder, melancholic specifier. But there has been controversy over whether diurnal variation is an unique depressive symptoms or a symptom related to a change of sleep patterns, or that of another mechanism, when the previous studies are reviewed. We investigated the existence of diurnal variation according to the subtype of depression and whether diurnal variation is charateristic of melancholic depression or not. We also compared sleep variables according to the existence of diurnal variation. Method: We examined diurnal variation, sleep patterns, severity of depression using the Visual Analogue Mood Scale, Pittsburgh Sleep Quality Index, and Hamilton Depression Rating Scale. Patients recorded their mood state on the Visual Analogue Mood Scale twice a day, morning and evening, for diurnal variation. We divided depressive patients into two groups,-diurnal variation group and nondiurnal variation group,-and compared the mood and sleep variables using SPSS. Results: The frequency of diurnal variation is not significantly different among the subtypes of depression. Significant differences between the diurnal variation group and the nondiurnal variation group existed in middle insomnia and sleep time (p<0.05). In melancholic type, al significant difference between the diurnal variation group and the nondiurnal variation group was noticed in PSQI total, sleep latency, sleep disturbances, daytime dysfunction as well as middle insomnia and sleep time (p<0.05). Conclusions: Diurnal variation existed in other types of depression as well as melancholic type. The results showed that diurnal variation was not a specific symptom of melancholic type, and existence of diurnal variation might be related to sleep patterns.

Melancholia;Diurnal variation;Sleep;