Gill D S, Ketter T A, Post R M
Biological Psychiatry Branch, US National Institutes of Mental Health, Bethesda, Maryland 20892.
Acta Psychiatr Scand. 1993 Feb;87(2):102-9. doi: 10.1111/j.1600-0447.1993.tb03338.x.
Three patients with treatment-resistant rapidly cycling bipolar disorder were studied with multiple sleep deprivations (SD) during several depressive episodes to assess the effect of phase or duration of a depressive episode on SD response. There was little response to SD early in a depressive episode, but responses were often robust late in an episode, sometimes triggering its termination. In 2 subjects, the duration of antidepressant response to SD increased linearly as time into episode increased. Neither the number of SD given in an episode nor the medication status of the patients appeared to account for the observed increases in antidepressant response. These results suggest that the neurobiological substrates underlying depression may change over the course of an episode, resulting in an increased responsivity to sleep deprivation later compared with earlier in the course of an episode in rapidly cycling patients. The generalizability of these findings to unipolar patients remains to be explored.
对三名难治性快速循环型双相情感障碍患者在几次抑郁发作期间进行了多次睡眠剥夺（SD）研究，以评估抑郁发作的阶段或持续时间对睡眠剥夺反应的影响。在抑郁发作早期，对睡眠剥夺几乎没有反应，但在发作后期反应通常很强烈，有时会引发发作的终止。在两名受试者中，随着发作时间的增加，对睡眠剥夺的抗抑郁反应持续时间呈线性增加。发作期间给予的睡眠剥夺次数和患者的用药状态似乎都不能解释观察到的抗抑郁反应增加。这些结果表明，抑郁症潜在的神经生物学底物可能在发作过程中发生变化，导致快速循环型患者在发作后期比早期对睡眠剥夺的反应性增加。这些发现对单相抑郁症患者的普遍性仍有待探索。
