A CONTROLLED TRIAL OF PHOTOTHERAPY IN RAPID-CYCLING BIPOLAR DISORDER

患有快速循环双相情感障碍的患者至少有四次发作 一年内患有情感性疾病(抑郁、轻躁狂和/或躁狂)。他们 患有严重的疾病，并经常对传统的 治疗。这些患者在睡眠觉醒时会经历戏剧性的变化。 随着他们情绪状态的变化而循环。此外，另一项研究的结果 (Z01 MH 02614-01 CP)在昼夜节律上表现出一致的差异 在抑郁和低躁狂状态下。自从用强光治疗以来 (光疗)已经被证明可以改变人类的昼夜节律，我们正在 对快速型青光眼患者进行光疗对照试验 骑自行车患双相情感障碍，看看强光是否可以用来改变他们的 昼夜节律，并缓解他们的抑郁症状 经验。 在整个研究过程中，患者保持稳定的精神药物治疗方案。 药物治疗。他们按顺序经历了几次抑郁发作 以建立他们疾病的基线模式。连续两次 然后对抑郁发作进行光疗(10,000个小时中的一个小时 Lux)。患者被随机分配到上午或晚上接受治疗 晚上，然后在第二个晚上转到另一个状态 这一集。情绪通过每天的自我评估和每周的观察者进行监测 收视率。在开始每种光疗条件的十天后， 病人在医院住一晚是为了接受一次 DLMO(暗光褪黑素发作)程序。在这个过程中， 病人被关在灯光昏暗的房间里，罕见的血液样本被提取到 测量褪黑激素分泌的开始时间。DLMO的目的是 确定光疗是否如预期的那样改变了患者的 昼夜节律。

Patients with rapid cycling bipolar experience at least four episodes of affective illness (depression, hypomania, and/or mania) in a year. They suffer significant morbidity and are frequently resistant to conventional treatments. These patients experience dramatic shifts in their sleep-wake cycle as their mood state changes. Furthermore, results from another study (Z01 MH 02614-01 CP) show consistent differences in their circadian rhythms in the depressed and hypomanic states. Since treatment with bright lights (phototherapy) has been shown to shift circadian rhythms in humans, we are conducting a controlled trial of phototherapy in patients with rapid cycling bipolar disorder to see if bright light can be used to shift their circadian rhythms and alleviate the depressive symptoms that they experience. Throughout the study, patients remain on a stable regimen of psychotropic medication. They are followed through several depressive episodes in order to establish the baseline pattern of their illness. two consecutive depressive episodes are then treated with phototherapy (one hour of 10,000 lux). Patients are randomly assigned to treatment in either the morning or evening, and then crossed over to the other condition during the second episode. Mood is monitored through daily self-ratings and weekly observer ratings. Ten days after beginning each of the phototherapy conditions, patients are admitted to the hospital for an evening in order to undergo a DLMO (dim light melatonin onset) procedure. During this procedure, patients are kept in a dimly lit room while blood samples rare withdrawn to measure the onset of melatonin secretion. The purpose of the DLMO is to determine whether the phototherapy has, as predicted, shifted the patients' circadian rhythms.