Wirz-Justice A. Sleep deprivation response in seasonal affective disorder during a 40-h constant routine

Abstract 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 5 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 5 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 $ 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