Rechlin T, Weis M, Schneider K, Zimmermann U, Kaschka W P
Department of Psychiatry, University of Erlangen-Nuremberg, Germany.
J Affect Disord. 1995 May 17;34(2):131-7. doi: 10.1016/0165-0327(95)00010-k.
30 inpatients suffering from major depression (DSM-III-R), who did not fulfill the criteria of seasonal affective disorder (SAD), were treated with either doxepin or amitripytyline as monotherapy and supportively with bright light for 14 days. From days 15 to 19, bright light was replaced by dim light. 18 drug-free control subjects underwent an analogous sequence of bright- and dim-light applications. Phototherapy was applied between 06:00 and 07:30. Heart-rate (HR) analysis was performed in the patients and control subjects before and after the 5th session of bright and dim lights, respectively. 12 patients (40%) experienced improvement of mood during bright-light therapy (group I) while 18 (60%) did not (group II). Patients of group I, who reached significantly higher scores in the seasonal pattern assessment questionnaire than patients of group II, showed an increase of the coefficient of HR variation (HRV) during deep breathing as well as an increment of the high-frequency (HF) peak of spectral analysis exclusively after the bright-light sessions. Patients of group II did not show a significant alteration of these parameters, neither under the conditions of bright-light treatment nor under dim light. The control subjects experienced an increment of the HF power exclusively after bright light. The results suggest that a distinct subgroup of patients with non-SAD major depression shows a more pronounced light-associated increment of parasympathetically controlled cardiac functions than the other depressed patients and the controls.(ABSTRACT TRUNCATED AT 250 WORDS)
30名患有重度抑郁症(DSM-III-R)且不符合季节性情感障碍(SAD)标准的住院患者,接受了多塞平或阿米替林单药治疗,并辅以强光照射14天。从第15天到第19天,强光被弱光取代。18名无药物治疗的对照受试者接受了类似的强光和弱光照射序列。光疗在06:00至07:30之间进行。分别在第5次强光和弱光照射前后对患者和对照受试者进行心率(HR)分析。12名患者(40%)在强光治疗期间情绪改善(I组),而18名患者(60%)未改善(II组)。I组患者在季节性模式评估问卷中的得分显著高于II组患者,他们仅在强光照射后深呼吸时心率变异性(HRV)系数增加,以及频谱分析的高频(HF)峰值增加。II组患者在强光治疗和弱光条件下这些参数均无显著变化。对照受试者仅在强光照射后高频功率增加。结果表明,与其他抑郁症患者和对照相比,非SAD重度抑郁症患者的一个特定亚组表现出与光相关的更明显的副交感神经控制心脏功能增加。(摘要截断于250字)