Humpston, C;
Benedetti, F;
Serfaty, M;
Markham, S;
Hodsoll, J;
Young, AH;
Veale, D;
(2020)
Chronotherapy for the rapid treatment of depression: A meta-analysis.
Journal of Affective Disorders
, 261
pp. 91-102.
10.1016/j.jad.2019.09.078.
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Abstract
BACKGROUND Chronotherapy (sleep deprivation, sleep phase shifting and/or the use of bright light) combines non-invasive and non-pharmacological interventions that may act rapidly against depressive symptoms. However, to date no meta-analysis has been conducted to examine their effectiveness. METHODS We carried out meta-analysis of 16 studies (four randomised controlled trials and 12 open-label case series) with between-subject comparisons between experimental and control conditions for RCTs and within-subject comparisons between baseline and follow-up for all studies. RESULTS Overall chronotherapy was generally superior to other therapies such as psychotherapy, antidepressants, exercise or light therapy alone after 5–7 days. For RCTs, chronotherapy was favoured (Hedge's g = 0.62, 95% CI 0.23–1.01) compared to control treatments such as antidepressants and exercise. 33.0% of patients were responders after 5–7 days in the chronotherapy group and 1.5% of patients in the control condition (OR = 7.58, 95% CI 2.03–28.28). For the case series, large effect sizes were found by 5–7 days (g = 1.78, 95% CI 1.49–2.07). In the case series, 61.6% of patients were classed as responders. LIMITATIONS The number of RCTs included in this meta-analysis was small, and the potential for risk of bias could not be ascertained accurately. One specific limitation is that studies nearly all included in-patients and the results may not be generalisable to out-patients, and nearly all the subjects lacked credibility ratings before receiving treatment. CONCLUSIONS Chronotherapy appears to be effective and well-tolerated in depressed patients. Nevertheless, further clinical and cost effectiveness studies are needed.
| Type: | Article |
|---|---|
| Title: | Chronotherapy for the rapid treatment of depression: A meta-analysis |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jad.2019.09.078 |
| Publisher version: | https://doi.org/10.1016/j.jad.2019.09.078 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Depression, chronotherapy, light therapy, meta-analysis, sleep deprivation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10091316 |
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