Sleep deprivation as a predictor of response to light therapy in major depression.
BACKGROUND
While the majority of depressed patients benefit from total sleep deprivation (TSD), light therapy is regarded as a first-line treatment only for seasonal affective disorder (SAD). The results of light therapy in nonseasonal major depressive disorder have been non-conclusive. We examined the correlation of TSD response and light therapy response in major depressed patients.


METHODS
40 inpatients with major depressive disorder (seven with seasonal pattern, 33 without seasonal pattern) were deprived of a night's sleep. The TSD responders, as well as the TSD nonresponders, were randomly assigned to receive adjunct light therapy either with bright white light (2500 lux) or dim red light (50 lux) during 2 weeks beginning on the third day after TSD.


RESULTS
The 20 TSD responders improved significantly better under the light therapy than the 20 TSD nonresponders (according to the Hamilton Depression Rating Scale and the self-rating depression scale Bf-S; v. Zerssen).


CONCLUSIONS
No significant difference could be found between the two light intensities. Since the patients were additionally treated with medication an interaction with the two adjunctive therapies cannot be excluded.


CONCLUSIONS
Our results indicate that a positive TSD response in major depressed patients can be predicative of beneficial outcome of subsequent light therapy.
Voss-Str. 2, Department of Psychiatry, University of Heidelberg, D-69115 Heidelberg, Germany.
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Fritzsche
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Heller
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Hill
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Kick
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010789:Phototherapy; D011237:Predictive Value of Tests; D012621:Seasons; D012892:Sleep Deprivation / Q000523:psychology; D016896:Treatment Outcome
D000928:Antidepressive Agents