A rate-limiting step in the prevention and early intervention of depressive disorders in young people is our insufficient understanding of causal mechanisms. One plausible pathophysiological pathway is disturbance in the 24 h sleep–wake cycle and the underlying circadian system. Abnormalities in circadian rhythms are well documented in adults with various depressive disorders and have been linked to core clinical features, including unstable mood, daytime fatigue, non-restorative sleep, reduced motor activity, somatic symptoms, and appetite and weight change. In this Review, we summarise four areas of research: basic circadian biology and animal models of circadian disturbances; developmental changes in circadian rhythms during adolescence and implications for the emergence of adolescent-onset depressive syndromes; community and clinical studies linking 24 h sleep–wake cycle disturbances and depressive disorders; and clinical trials of circadian-based treatments. We present recommendations based on a highly personalised, early intervention model for circadian-linked depression in young people.

预防和早期干预年轻人抑郁症的一个限速步骤是我们对因果机制的了解不足。一种可能的病理生理途径是 24 小时睡眠-觉醒周期和基础昼夜节律系统的紊乱。昼夜节律异常在患有各种抑郁症的成年人中得到充分证明，并且与核心临床特征有关，包括情绪不稳定、白天疲劳、非恢复性睡眠、运动活动减少、躯体症状以及食欲和体重变化。在这篇综述中，我们总结了四个研究领域：基础昼夜节律生物学和昼夜节律紊乱的动物模型；青春期昼夜节律的发展变化以及对青春期抑郁综合征出现的影响；将 24 小时睡眠-觉醒周期紊乱和抑郁症联系起来的社区和临床研究；和基于昼夜节律的治疗的临床试验。我们基于高度个性化的早期干预模型提出建议，用于治疗与昼夜节律相关的年轻人抑郁症。