Total sleep deprivation followed by sleep phase advance and bright light therapy in drug-resistant mood disorders
Total sleep deprivation followed by sleep phase advance and bright light therapy in drug-resistant mood disorders
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DOI：
10.1016/j.jad.2012.06.022
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发表时间：
2013-01-10
影响因子：
6.6
通讯作者：
Shimizu, Tetsuo
中科院分区：
文献类型：
--
作者：
Echizenya, Masaru;Suda, Hideka;Shimizu, Tetsuo
背景资料：耐药抑郁症是精神病学中的一个主要治疗问题，需要开发治疗耐药抑郁症的非药物疗法。睡眠剥夺（SD）是一种非药物治疗，除了明亮的光疗法（BLT）和睡眠相位提前（SPA）之外，还被归类为时间疗法的一种形式。联合时间疗法被认为可以改善耐药抑郁症。在这项研究中，我们调查的好处，总睡眠剥夺（TSD），然后SPA和BLT在耐药抑郁症，同时正在进行的抗抑郁药物治疗，并观察了额外的有效性相结合的chronotherapy.Methods：13耐药的住院患者受抑郁症发作进行了研究。他们接受了TSD治疗，然后是SPA（3天）和BLT（5天），并持续进行药物治疗。采用汉密尔顿抑郁量表（HAM-D）、Zung抑郁自评量表（SDS）和视觉焦虑量表（VAS）评定疗效。在整个研究期间，13名患者中有8名患者保持了这种反应性（HAM-D的变化≥ 50%）。此外，没有患者脱落的组合chronotherapy procedure.Limitations：该研究没有安慰剂组，更多的科目可能needed.Conclusion：试验的组合chronotherapy成功地诱导快速改善抑郁症状的耐药患者没有早期复发或明显的副作用。(C)2012爱思唯尔有限公司版权所有。
Background: Drug-resistant depression is a major therapeutic issue in psychiatry and the development of non-drug therapies that treat drug-resistant depression is required. Sleep deprivation (SD) is a non-drug treatment classified as a form of chronotherapy in addition to bright light therapy (BLT) and sleep phase advance (SPA). Combined chronotherapy is hypothesized to improve drug-resistant depression. In this study, we investigated the benefits of total sleep deprivation (TSD) followed by SPA and BLT in drug-resistant depression alongside ongoing antidepressant medication and observed the added effectiveness of the combined chronotherapy.Methods: Thirteen drug-resistant inpatients affected by a major depressive episode were studied. They were treated by TSD followed by SPA (three days) and BLT (five days) with ongoing drug treatment. Effectiveness was rated using the Hamilton Rating Scale for Depression (HAM-D), the Zung Self-Rating Depression Scale (SDS), and the Visual Analogue Scale (VAS) over 3 weeks.Results: Significant improvements of depressive symptoms were observed in both objective mood ratings (HAM-D) and subjective mood ratings (SDS and VAS). Eight out of 13 patients maintained this responsiveness (50% or greater changes in HAM-D) across the study period. Moreover, no patients dropped out of the combined chronotherapy procedure.Limitations: The study did not have a placebo group, and more subjects may be needed.Conclusion: The trial of combined chronotherapy successfully induced rapid improvement in depressive symptoms in drug-resistant patients without early relapse or obvious side effects. (C) 2012 Elsevier B.V. All rights reserved.