University of Groningen
Rhythm & Blues Knapen, Stefan Erik
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Publication date: 2019
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Knapen, S. E. (2019). Rhythm & Blues: Chronobiology in the pathophysiology and treatment of mood disorders. Rijksuniversiteit Groningen.
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Stefan E. Knapen
Chronobiology in the pathophysiology
and treatment of mood disorders
Colophon
The research in this thesis was supported by grants from the NIMH (R01 MH090553), foundation de Drie Lichten and the Ubbo Emmius Fonds Talent Grant.
Publications of this thesis was generously supported by the University of Groningen, University Medical Center Groningen, the Research School for Behavioral and Cognitive Neuroscience, de Nederlandse vereniging voor Slaap – Waak Onderzoek and de vakgroep Neurologie Reinier de Graaf Gasthuis.
Cover design & lay-out: Ellen Beck, www.ellenbeck.nl Printed by: Ridderprint, the Netherlands
ISBN printed version: 978-94-034-1536-9 ISBN digital version: 978-94-034-1537-6
Rhythm & Blues
Chronobiology in the pathophysiology and treatment of mood disorders
Proefschrift
ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen
op gezag van de
rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties.
De openbare verdediging zal plaatsvinden op woensdag 17 april 2019 om 16.15 uur
door
Stefan Erik Knapen
geboren op 29 november 1990 te Apeldoorn
Promotor
Prof. dr. R.A. Schoevers
Copromotor
Dr. R.F. Riemersma-van der Lek
Beoordelingscommissie
Prof. dr. E. van Someren Prof. dr. A. Wirz-Justice Prof. dr. W.A. Nolen
Rhythm & Blues
Chronobiology in the pathophysiology and
treatment of mood disorders
Table of contents
Chapter 1: Introduction 9
Mood disorders
Rhythm and the circadian timing system Vulnerability to mood disorders
Link between mood disorder and rhythm problems Treatment of mood disorder through rhythm
Thesis outline
References
Chapter 2: Association of circadian genes with chronotype and mood disorder, an analysis of
epidemiological and translational data 19A
Abstract Introduction
Material and methods Results
Discussion References
Chapter 3: Social jetlag and depression status: results from the Netherlands Study of Depression
and Anxiety 34
Abstract Introduction
Material and methods Results
Discussion
Supplemental material References
Chapter 4: Letter to the editor: Chronotype not
associated with non-remission, but with current state? 48
Chapter 5: Circadian rhythm disturbances in bipolar disorder: an actigraphy study in patients, unaffected
siblings and healthy controls 52
Abstract Introduction
Material and methods Results
Discussion References
Chapter 6: Coping with a life event in bipolar disorder – ambulatory measurement,
signalling and early treatment 65
Summary Background Case presentation Treatment
Outcome and follow-up Discussion
References
Chapter 7: The temporal order of sleep disturbances and mood changes before the transition to a mood
episode in bipolar disorder 71
Abstract Introduction
Material and methods Results
Discussion References
Chapter 8: Fractal biomarker of activity in patients
with bipolar disorder 94
Abstract Introduction Methods Results Discussion References
Chapter 9: The duration of light treatment and
therapy outcome in Seasonal Affective Disorder 107
Abstract Introduction
Material and Methods Results
Discussion References
Chapter 10: The relation between chronotype and treatment outcome with light therapy on a
fixed time schedule 116
Abstract Introduction Methods Results Discussion References
Chapter 11: General discussion 124
Part 1: Vulnerability factors for developing mood disorders Part 2: Rest-activity rhythms and mood – actigraphy
Part 3: Therapeutic options with chronobiological mechanisms General discussion Conclusions References Chapter 12: Addenda 139 Samenvatting Dankwoord Publications Curriculum Vitae
