Chronotherapeutic treatments for depression in youth
Abstract
Chronotherapeutics such as wake therapy and bright light therapy are well-established methods in treating adults with depressive disorders and are additionally beneficent for sleep regulation. Few studies concerning chronotherapeutics in juvenile depression exist, though the established treatments are insufficient and sleep disorders often co-occur. In this study, we investigate the impact of two types of chronotherapeutics on depressive symptoms and sleep behavior in a juvenile setting. Juvenile inpatients (n = 62) with moderate to severe depressive symptoms took part in either a combined setting consisting of one night wake therapy followed by 2 weeks bright light therapy or in a setting of bright light therapy alone. Depressive symptoms, general psychopathology, clinical impression and sleep behavior were measured before (T1), directly after (T2) and 2 weeks after intervention (T3). Depressive symptoms decreased while sleep quality increased in both groups. The bright light therapy alone group showed further improvement at T3 in regards to depressive symptoms. Correlation analyses indicated significant negative correlations between sleep quality and awaking after restorative sleep with the depressive symptoms. However, only awaking after restorative sleep had a predictive impact on treatment outcome. The present study provides first evidence for a positive impact of chronotherapeutic interventions on treatment outcome in depressed juvenile inpatients. Bright light therapy seems to stabilize and further enhance reduction of depressive symptoms during follow-up, whereas one night wake therapy does not have an additional long-lasting impact on depressive symptoms and sleep parameters.
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Another randomized controlled trial evaluated 1-night TSD as add-on to BLT in juvenile depressed inpatients and found no additive effect of TSD on sleep quality or on depressive symptoms.
“Moreover, another RCT evaluated 1-night TSD as add-on to BLT in juvenile depressed inpatients (44). No additive effect of TSD on sleep quality or on depressive symptoms was found.”
From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [44]
Recent studies on combined chronotherapy have reported lower response rates than the presumed average of 50% with the exception of two cohort studies.
“Moreover, recent studies on combined chronotherapy have reported lower response rates (20, 39, 44, 58) than the presumed average of 50% (45) with the exception of two cohort studies (22, 62).”
From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [44]
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Self-citation
- Authors
- Gest, S., Holtmann, M., Bogen, S., Schulz, C., Pniewski, B., & Legenbauer, T.
- Affiliations
- LWL-Universitätsklinik Hamm (DE)
- Corresponding author
- Gest, Stephanie
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2015-05-17
- Volume
- 25
- Issue
- 2
- Pages
- 151-161
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- OpenAlex
- W283531375
- Cited by
- 32
- References
- 59
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 5 · 2017: 4 · 2016: 1
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- chronotherapy, adolescent depression, bright light therapy, wake therapy, sleep quality, sleep behavior, depressive symptoms, adolescent inpatients, treatment outcomes, restorative sleep
- MeSH terms
- Adolescent, Adult, Depression, Depressive Disorder, Female, Follow-Up Studies, Humans, Inpatients, Male, Middle Aged, Phototherapy, Severity of Illness Index, Sleep, Sleep Wake Disorders, Treatment Outcome, Chronotherapy, Young Adult, Sleep Phase Chronotherapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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