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Sleep deprivation a...
Sleep deprivation as treatment for depression: Systematic review and meta-analysis
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- Ioannou, Michael (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Wartenberg, C. (author)
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- Greenbrook, Josephine T. V., 1984 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
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- Larson, Tomas, 1967 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Magnusson, K. (author)
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Schmitz, L. (author)
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Sjogren, P. (author)
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Stadig, I. (author)
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Szabo, Z. (author)
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- Steingrimsson, Steinn (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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(creator_code:org_t)
- 2020-12-27
- 2021
- English.
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In: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 143:1, s. 22-35
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Abstract
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- Objective To systematically review evidence on the efficacy and safety of sleep deprivation (SD) as a treatment option for patients with unipolar or bipolar depression. Methods A systematic review according to PRISMA guidelines was conducted. The certainty of evidence was assessed using the GRADE approach. Controlled trials were included in efficacy analysis, case series for evaluating complications and qualitative studies for patients' experiences. Results Eight controlled studies (368 patients), one qualitative study and seven case series (825 patients) were included. One week after treatment start, SD combined with standard treatment did not reduce depressive symptoms compared with standard treatment (standardized mean difference, SMD = -0.29, [95% confidence interval, CI: -0.84 to 0.25], p = 0.29). When excluding a study in elderly patients in a post hoc analysis, the difference was statistically significant (SMD = -0.54 ([95% CI: -0.86 to -0.22], p < 0.001)) but it diminished two weeks after treatment start. No superiority of SD was found compared with antidepressants, but SD may be superior to exercise in certain settings. It is uncertain whether SD affects quality of sleep, quality of life, everyday functioning or length of stay. Apart from switch to mania (ranging between 2.7% and 10.7%), no other serious complications were reported. Conclusion Sleep deprivation has been studied in a wide range of settings resulting in divergent results for the short-term efficacy on depressive symptoms. Post hoc analyses indicated that there may be a significant but transient effect in certain populations. Further studies should focus on identifying subgroups of responders as well as examining feasibility in routine clinical care.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- bipolar syndrome
- chronotherapy
- depression
- meta‐
- analysis
- systematic review
- star-asterisk-d
- light therapy
- bipolar depression
- rating-scale
- heterogeneity
- improvement
- switch
- mania
- trial
- wake
- Psychiatry
Publication and Content Type
- ref (subject category)
- for (subject category)
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- By the author/editor
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Ioannou, Michael
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Wartenberg, C.
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Greenbrook, Jose ...
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Larson, Tomas, 1 ...
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Magnusson, K.
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Schmitz, L.
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show more...
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Sjogren, P.
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Stadig, I.
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Szabo, Z.
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Steingrimsson, S ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Psychiatry
- Articles in the publication
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Acta Psychiatric ...
- By the university
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University of Gothenburg