ABSTRACT
BACKGROUND: Melatonin, which plays an important role for regulation of circadian rhythms and the sleep/wake cycle has been linked to the pathophysiology of major depressive and bipolar disorder. Here we investigated melatonin levels in cerebrospinal fluid (CSF) and serum of depression and bipolar patients to elucidate potential differences and commonalities in melatonin alterations across the two disorders. METHODS: Using enzyme-linked immunosorbent assays, CSF and serum melatonin levels were measured in 108 subjects (27 healthy volunteers, 44 depressed and 37 bipolar patients). Covariate adjusted multiple regression analysis was used to investigate group differences in melatonin levels. RESULTS: In CSF, melatonin levels were significantly decreased in bipolar (P<0.001), but not major depressive disorder. In serum, we observed a significant melatonin decrease in major depressive (P=0.003), but not bipolar disorder. No associations were found between serum and CSF melatonin levels or between melatonin and measures of symptom severity or sleep disruptions in either condition. CONCLUSION: This study suggests the presence of differential, body fluid specific alterations of melatonin levels in bipolar and major depressive disorder. Further, longitudinal studies are required to explore the disease phase dependency of melatonin alterations and to mechanistically explore the causes and consequences of site-specific alterations.
Subject(s)
Bipolar Disorder/physiopathology , Circadian Rhythm/physiology , Depressive Disorder, Major/physiopathology , Melatonin/blood , Melatonin/cerebrospinal fluid , Adult , Bipolar Disorder/diagnosis , Bipolar Disorder/metabolism , Case-Control Studies , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/metabolism , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Melatonin/metabolism , Middle Aged , Regression AnalysisABSTRACT
What has been changed in the system of social help since sexual abuse became a public topic? Is social work capable of providing adequate help and support for the survivors? The article presents the results of a three-year-lasting research project. In three different regions the authors have scrutinized 1. the institutions offering help, 2. the knowledge of and the attitude towards sexual violence of the professionals and 3. the conceptional assumptions leading social work. The results show that the situation for survivors of sexual abuse has definitely improved, because there are more helping institutions and the professional awareness has increased. But for a profound reorganization of help, restrictive financial politics, internalized prejudices and institutional concepts need to be changed.
