Effects of sleep deprivation on depressed patients of different nosological groups.

In a study of 80 patients who received 164 treatments with sleep deprivation, the following questions were addressed: Do depressive patients of different subgroups respond differently to sleep deprivation? what complications arise? does the same patient react in the same way to multiple treatments? are there differences between responders and nonresponders? Results indicate that: (1) Endogenous depressions (unipolar, bipolar, and involutional) and psychotic depressions in schizophrenic patients improve significantly the day after sleep deprivation. However, on the second day, after a night's recovery sleep, a significant improvement occurs in neurotic depressives, whereas the endogenous and psychotic depressions worsen again. (2) Schizophrenic patients with a postpsychotic depression respond as well to sleep deprivation as patients with bipolar depression. (3) Complications arise very rarely in sleep deprivation therapy. (4) Patients in all the diagnostic categories studied can respond very differently to multiple treatments with sleep deprivation. (5) Responders and nonresponders do not differ in age, sex, or psychopathological state before sleep deprivation, and psychotropic drugs have no apparent effect on the therapeutic response.