linking moods with 'humors' in the
blood may have some validity
A School of Medicine and Veteran's lAffairs Administration study finding that patients with Seasonal Affective Disorder (SAD) have lower nighttime levels of bilirubin in their blood lends support to ancient theories about moods.
Bilirubin is a bile pigment found in the blood and was known by ancient Greek physicians as a "humor." The study is the first-ever scientific investigation of cyclical, or circadian, levels of bilirubin in the blood of people with depression.
Principal investigator of the study Dr. Dan A. Oren, associate professor of psychiatry, says, "Humoral theories of mood depending upon bile pigments date back to the dawn of Western medicine. We know of no other studies of circadian bilirubin measurement in seasonal or other forms of depression. Low nocturnal levels of bilirubin may be a clue to understanding the causes and treatment of winter depression." An abstract of an article about the study is published on the journal Biological Psychiatry's website at www-east.elsevier.com/bps.
The investigators found that nighttime bilirubin levels were lower in nine patients with SAD compared to a group of seven age- and gender-matched, healthy volunteers. The patient group was also found to have increased levels of bilirubin following treatment with exposure to a light source, a standard form of therapy for the disorder.
According to Oren, SAD affects up to 10% of people in the northern United States. Treatment studies of SAD have centered on the effects of light on mood, but the reasons why light is an effective treatment and how seasonally lower exposure to light may lead to SAD remain a mystery.
Bilirubin, which is found in the blood, is known to be sensitive to light and to be able to cross the blood-brain barrier. It is also known to have a circadian rhythm in which blood levels of bilirubin gradually increase during the night and decrease during the day.
Oren hopes to follow this study with a larger sample of subjects and to study subjects this winter throughout the day and night. This will help determine whether lower levels of bilirubin are a causal factor for SAD or a marker for the disorder.
Funding for the study, which included the work of Oren's former Yale colleague Dr. Dennis Charney, now of the National Institute of Mental Health (NIMH) in Bethesda, Maryland, came from a Veterans Affairs Career Development Award and a Pilot Grant from the NIMH-supported Yale University Mental Health Clinical Research Center.
Other authors on the study include Yale researchers Dr. Paul H. Desan, Nashaat Boutros and Amit Anand.
-- By Karen Peart
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