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Volume 34, issue 4

Original article

Sleep deprivation with sleep phase advance in treatment-resistant depression therapy in relation to features of circadian rhythm and temperament – a pilot study

Ewa Kurczewska1, Janusz Rybakowski2, Ewa Ferensztajn-Rochowiak1, Maria Chłopocka-Woźniak1
1. Klinika Psychiatrii Dorosłych UM w Poznaniu
2. Klinika Psychiatrii Dorosłych UM w Poznaniu, Klinika Psychiatrii Dzieci i Młodzieży UM w Poznaniu
Farmakoterapia w Psychiatrii i Neurologii 2018, 34 (4), 249–262
DOI: https://doi.org/10.33450/fpn.2019.01.001
Keywords: sleep deprivation, treatment-resistant depression, affective temperaments, chronotype

Objectives. The efficacy of pharmacotherapy augmentation by total sleep deprivation (TSD) with sleep phase advance (SPA) was evaluated in patients with treatment-resistant depression (TRD). The study examined the relationship between chronotype, affective temperaments and clinical improvement resulting from the treatment.

Material and methods. The study group comprised of 30 persons with treatment-resistant unipolar (n = 15) or bipolar (n = 15) depression aged 52 ± 12 years (17 women and 13 men). TSD and three consecutive nights with SPA were used during pharmacotherapy. Severity of depression was determined using the Hamilton Depression Rating Scale (HDRS). All patients were assessed using the Composite Scale of Morningness (CSM) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A).

Results. Clinical response, defined as a reduction in the severity of depression by ≥ 50% in HDRS compared to the baseline score, lasting until the end of the study (14 days), was obtained in 16 out of 30 patients with TRD. There was found no significant correlation between clinical improvement, chronotype and affective temperaments.

Conclusions. TSD with SPA proved to be an effective method of pharmacotherapy augmentation in over half of the patients with TRD. The relationship between chronotype, affective temperaments and the clinical response to chronotherapy of depression requires further research.

Address for correspondence:
Ewa Kurczewska
Klinika Psychiatrii Dorosłych UM w Poznaniu
ul. Szpitalna 27/33, 60-572, Poznań, Poland
email: dopierala.ewa@gmail.com