Longitudinal Studies of Diurnal Variations in Depression: A Sample of 643 Patient Days

Abstract

Diurnal variations in symptom intensity have long been recognized as a characteristic feature of depression, and have always had a prominent place in clinical descriptions of the illness. A worsening of depression in the morning has classically been associated with endogenous depression, while a worsening in the evening has been described as characteristic of reactive or neurotic depression (Kiloh and Garside, 1963; Winokur, Clayton and Reich, 1969). Yet, in spite of the widely held belief of the diagnostic relevance of diurnal patterns, little systematic research on these patterns has been reported.