[Chronotherapeutic approaches in depressive disorders].

Sleep deprivation has been regarded as a beneficial treatment modality for about 60% of patients with Major Depressive Disorder. Unfortunately, however, more than 80% of the improved patients relapse into depression after the next night of sleep. In the present study we tried to prevent relapses into depression after successful total sleep deprivation (TSD) by treating 27 patients suffering from a Major Depressive Disorder according to DSM-III-R with a combination of sleep deprivation with consecutive sleep phase advance for 1 week. Advancing the sleep period to 5.00 p.m. until 12.00 p.m. following TSD and then gradually shifting back by 1 h daily the sleep period to the normal phase position (11.00 p.m. until 6.00 a.m.) prevented 61% of these patients from relapsing into depression. Thus, the combination of sleep deprivation with consecutive sleep phase advance has been proven to be an effective antidepressant treatment besides other well established antidepressive treatment modalities.