Abstinence from night sleep as a treatment for endogenous depressions. The earliest observations in a Danish mental hospital (1954) and an analysis of the causal mechanism.
In the early 1950s before antidepressants were in use, I conceived the idea of treating patients with pure endogenous depressions by having them abstain from night sleep for two or more nights. The idea was based on several clinical observations: "It looks as if sleep as such has an unfortunate influence on the state of the depression and as if the organism itself resists the sleep rhythm during the period of depression." My first clinical experiment was conducted in June 1954 and was followed later by several others. At that time, I could not ascertain from the available literature whether this therapy had been tried elsewhere. The experiments completely confirmed that the hypothesis was correct--that the patients' condition had improved and that the treatment influenced the subcortical processes which determined the complaint. This led to studies on the transmitter function in the states of sleeping and waking, respectively, among healthy and sick people or, more precisely, the influence of darkness and light, respectively, on these functions. The studies appeared to confirm that therapy in which the patient is kept awake encourages the production of activating substances such as antidepressants. The most recent research on melatonin, which is formed in the corpus pineale, is briefly discussed. Provisional results seem to indicate that this substance has an inhibiting effect on vital brain functions in periods of darkness (periods of sleep) and thus contributes to the maintenance of the depression because melatonin is especially produced in the dark periods of the daily cycle. These investigations, though still at an experimental stage, suggest exciting possibilities, also for psychiatry.(ABSTRACT TRUNCATED AT 250 WORDS)
D002940:Circadian Rhythm; D003866:Depressive Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D010870:Pineal Gland / Q000503:physiopathology; D012008:Recurrence; D012701:Serotonin / Q000378:metabolism; D012892:Sleep Deprivation; D012894:Sleep Stages / Q000502:physiology
D012701:Serotonin