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Sleep deprivation response in seasonal affective disorder during a 40-h constant routine
P Graw1, H J Haug, G Leonhardt
1Chronobiology and Sleep Laboratory, Psychiatric University Clinic, Basel, Switzerland.
Background:
There are no controlled studies investigating the response of patients with seasonal affective disorder (SAD) to a total sleep deprivation (SD).
Methods:
The clinical response to SD of patients with SAD in winter was investigated under the stringently controlled conditions of a 40-h constant routine protocol.
Results:
52% of the SAD patients (N=11 women) improved, using a mean of a multiple ratings. This is in the range of response found for non-seasonal major depression. In contrast, controls (N=8 women) showed less improvement of mood (29%).
Conclusion:
SAD patients respond to SD as do non-seasonal major depressives. The best discrimination of response was obtained in an observer rating (Clinical Global Impression: global severity improvement), and the morning values of two different self ratings (v. Zerssen depression scale, 100 mm VAS with the criterion of > or =10 mm improvement).
Limitation:
A more reliable estimate of the SD response rate in SAD patients would require a larger group.
Clinical Relevance:
SAD patients do not differ from other subgroups of major depression in their response to SD, and therefore this is an additional treatment option to light therapy.