5% afternoon, and 48.6% evening worsening. Melancholic symptom features were associated with DV, regardless of pattern. Using a neuropsychological test battery, the morning pattern of impairment in the melancholies was comprehensive, affecting attention and concentration/working memory, episodic memory, reaction time, and speed of simultaneous match to sample.18 Significantly improved neuropsychological function was seen in the melancholic patients in the evening, in line with diurnal improvement in mood. Some functions remained impaired in the evening compared with controls; others improved. Inhibitors,research,lifescience,medical Another study also found that complex tests of executive function were sensitive measures of DV19 Mood variability

‘ITic concept of mood variability, rather than Inhibitors,research,lifescience,medical any specific pattern of mood change, has arisen from long-term studies.20 Women with premenstrual syndrome had greater mood variability than normal subjects. Patients with borderline personality disorder also revealed a high degree of mood variability, but random in nature from one day to the next.20 ‘This suggests that mechanisms regulating mood stability may differ from those regulating overall mood state. Dynamic patterns of mood variation were revealed using complex time series analyses of self-assessments of Inhibitors,research,lifescience,medical anxiety and depression for each hour awake during a 30-day period.21 Controls

displayed circadian rhythms with underlying chaotic variability, whereas depressed patients no find more longer had circadian rhythms, but. retained chaotic dynamics. Days with no DV or with typical DV (morning low, afternoon/evening high) occurred with similar frequency in both melancholic patients and

controls.22 In other words, circadian mood variations vary substantially inter- Inhibitors,research,lifescience,medical and intraindividually. Interesting are the attributions: melancholic patients experience spontaneous mood variations as uninfluenceable, whereas healthy controls consider them almost exclusively related to their own activities and/or external circumstances.22 DV and chronotype Many of the above findings of worse morning mood suggest, a late chronotype in MDD. Three new Inhibitors,research,lifescience,medical studies have looked at large populations of bipolar patients, and replicably found a predisposition for late chronotypes.23-25 Additionally, individuals aminophylline with higher depression scores are more likely to be late chronotypes.25 One of the characteristics of circadian rhythms is that the lower the strength of synchronizing agents (zeitgebers), the later they drift. Less light, exposure in winter could underline the reported delayed chronotype in winter depression.26 Could the lower lifestyle regularity and activity level indices (as codified in the Social Rhythm Metric) in bipolar disorder patients compared with controls be an indication of such a diminution of zeitgebers?27 In addition, the timing of five, mostly morning, activities was phase-delayed in patients not only compared with control subjects but with themselves when well.