Sleep deprivation therapy in depression

Abstract

Females (62) and males (15), aged 20-72, with monopolar (60 patients) and bipolar (17 patients) types of manic-depressive psychosis were studied. Of these patients, 30 had suffered only the current depression, 29 a maximum of 5 depressions, and 18 more than 5 depressions before the sleep deprivation therapy. Patients (25) had been treated with antidepressant drugs for less than 10 days, 12 patients for 10-24 days and 36 patients for more than 24 days. Patients (24) were treated with 1 sleep deprivation, 29 patients with 1 sleep deprivation per wk (average 1.59), and 24 patients with 2 sleep deprivations/wk (average 2.5). The effect of the sleep deprivation therapy was evaluated clinically and by means of Cronholm-Ottosson''s rating scale. The effect was good and lasting in 29%, good but temporary in 38%, and poor in 32% of the cases. The best results were achieved with twice-weekly treatments, the poorest results with once-weekly treatment. The results were equal in monopolar and bipolar cases and were independent of the number of previous depressions as well as antidepressant drug treatment. No side-effects were observed, in particular no conversion to mania. Depression and sleep disturbances were symptoms produced by a common factor which is as yet unknown. Sleep deprivation therapy had at least some effect on all cases of endogenous depression. Sleep deprivation therapy had no side-effects and was more quick-acting than any other treatment procedure hitherto known. It should therefore be considered the 1st treatment offered to all endogenously depressed patients in whom immediate ECT [electric convulsive therapy] was not necessitated.