Chronotherapeutics for Affective Disorders ：A Clinician's Manual for Light and Wake Therapy, 2nd, revised edition

Publication subTitle ：A Clinician's Manual for Light and Wake Therapy, 2nd, revised edition

Author： Wirz-Justice A.; Benedetti F.; Terman T.  

Publisher： S. Karger AG‎

Publication year： 2013

E-ISBN: 9783318020915

P-ISBN(Paperback): 9783318020908

Subject： R749.4 affective psychosis

Keyword： 心理学,神经病学与精神病学,预防医学、卫生学

Language： ENG

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Description

Light therapy' is established worldwide as the treatment of choice for seasonal affective disorder. It is also successfuly used in nonseasonal depression, as well as for many other psychiatric and neurologic illnesses, and in sleep medicine. ‘Wake therapy’ is the fastest antidepressant known. Imaging studies show that both methods share neurobiological substrates with antidepressants, but act much faster. 'Chronotherapeutics' – the combination of light and wake therapy – achieves rapid results and, by reducing residual symptoms, also minimises relapse. Written by three prominent clinical and research experts in biological rhythms, this manual aims to broaden knowledge and practical application of these non-pharmacologic interventions for bipolar and unipolar disorders. Clinical understanding is deepened by an explanation of the circadian timing system and sleep regulatory mechanisms which underlie the novel treatment strategy. The step-by-step guide and description of the interventions in centers throughout the world provides clear hands-on instructions, supported by a solid body of clinical research. The first edition of 'Chronotherapeutics for Affective Disorders' has kindled a network of psychiatrists and psychologists who are actively introducing these treatments for their inpatients and outpatients. This manual is also essential reading for primary care physicians, sleep medicine specialists and health care administrators.

Chapter

Cover

Front Matter

Contents

Foreword

Acknowledgements

List of Abbreviations

Introduction

Unmet Needs in the Treatment of Depression

Role of Biological Rhythms in Psychiatry

Principles of Sleep Regulation

Mood Level Varies with Time of Day and Duration of Wakefulness

Sleep Deprivation

How It All Began: Light Therapy for Seasonal Affective Disorder

Light Therapy – Beyond SAD

What Is Chronotherapeutics?

How Does Chronotherapeutics Work?

Individual Chronotherapeutic Elements: Light, Wake Therapy and Sleep Phase Advance

Efficacy of Bright Light Therapy for SAD

Timing of Bright Light Therapy

Dawn (and Dusk) Simulation Therapy

Efficacy of Bright Light Therapy for Non-Seasonal Depression

Dark Therapy

Wake Therapy

Phase Advance of the Sleep-Wake Cycle

Negative Air Ionisation

Integrative Chronotherapeutics: Combinations of Light, Wake Therapy and Sleep Phase Advance

A Note on Diagnostic Differences

Bright Light Augmentation of Antidepressant Drug Treatment

Wake Therapy Added to Medication

Wake and Light Therapy Added to Antidepressant Drugs or Mood Stabilisers

Wake, Light, and Sleep Phase Advance Therapy

Repeated Wake Therapy

Inpatient Procedures

Response Assessment and Monitoring

Light Therapy Timing and Duration

Exceptions to the Early Morning Light Rule for Bipolar 1 Disorder

Beginning with Light Therapy (8 Medication)

Wake Therapy + Light Therapy

Wake Therapy + Light Therapy + Sleep PhaseAdvance

Three Alternate Nights of Wake Therapy +Light Therapy + Freely Chosen Sleep Phase Advance

Variations on the Theme

Maintenance Treatment

Drug Tapering to Discontinuation

Practical Details for Wake Therapy

Which Patients Are Suitable?

Predictors of Response

Medication Allowances and Contraindications

What to Tell Patients

Setting and Structure for the Night Awake

Staff Monitoring

Nurses on the Night Shift

Nurses on the Day Shift after Wake Therapy

Structure of the Day After

Phase Advance of Sleep following Wake Therapy

The Doctor’s Tasks

Is One-Time Wake Therapy Enough?

Safety

Special Conditions

If There Is No Response

At the End of One Week of Chronotherapeutics

Relapse

In Conclusion

Practical Details for Light Therapy

Criteria for Light Box Selection

Using the Light Box

Side Effects of Light Therapy

Cautionary Notes about Bright LightExposure

Before Beginning Light Therapy

In Conclusion

Outpatient Treatment Strategies

Light Therapy

A Daily Walk Outdoors

Wake Therapy

Range of Chronotherapeutic Indications

Antepartum Depression

Premenstrual Dysphoric Disorder

Eating Disorders

Attention Deficit/Hyperactivity Disorder

Dementia

Parkinson’s Disease

Shift Work and Jet Lag Disturbance

Other Psychiatric Disorders

Medical Applications

Light Therapy for Children and Adolescents

Light and Wake Therapy for Older Patients

The Visually Impaired: More Sleep Disturbances, More Depression

Endogenous and Exogenous Melatonin

The Physiological Effects of Melatonin

Melatonin in Circadian Sleep-Wake Cycle Disturbances

Melatonin for Depression?

Drugs That Affect Rhythms (Chronobiotics)

Melatonin Agonists

Chronobiology of Lithium and Antidepressants

Clock Genes in Depression

Caffeine, Modafinil

Social Rhythm Therapy

Chronobiology in Everyday Life

Know Your Chronotype

Timing of School and Work Schedules versus Sleep

Light and the Built Environment: Implicationsfor Architecture

References

Subject Index

Appendix

Authors

Cover

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