Sleep deprivation as a predictor of response to light therapy in major depression

Background: While the majority of depressed patients benefit from total sle ep deprivation (TSD), light therapy is regarded as a first-line treatment o nly 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 depres sed patients. Methods: 40 inpatients with major depressive disorder (seven with seasonal pattern, 33 without seasonal pattern) were deprived of a nigh t's sleep. The TSD responders, as well as the TSD nonresponders, were rando mly assigned to receive adjunct light therapy either with bright white ligh t (2500 lux) or dim red light (50 lux) during 2 weeks beginning on the thir d day after TSD. Results: The 20 TSD responders improved significantly bett er 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). Limitations: No significant difference could be found between the two light intensities. Since the patients were additionally treated wi th medication an interaction with the two adjunctive therapies cannot be ex cluded. Conclusion: Our results indicate that a positive TSD response in ma jor depressed patients can be predicative of beneficial outcome of subseque nt light therapy. (C) 2001 Elsevier Science BN. All rights reserved.