Sleep deprivation response in seasonal affective disorder during a 40-h constant routine

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 = 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 = 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 greater than or equal to 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. (C) 1998 Elsevier Science B.V.