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Les temps de la dépression

Published online by Cambridge University Press:  28 April 2020

P. Lemoine  and
J. Mouret
P. Lemoine
Affiliation:
Unité clinique de psychiatrie biologique, CHRS Le Vinatier, 69677Lyon-Bron
J. Mouret
Affiliation:
Unité clinique de psychiatrie biologique, CHRS Le Vinatier, 69677Lyon-Bron Département de physiologie, Université Lyon I, France
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Résumé

Revue à travers les données de la littérature, la dépression apparaît comme un sujet de recherche très important, qui a déjà suscité de nombreuses théories chronobiologiques, souvent fondées sur des ≪critères diagnostiques objectifs≫. En revanche, l’impact thérapeutique de ces approches reste souvent limité à de rares services ultraspécialisés où les patients déprimés sont adressés en dernier recours.

Dans cet article, les auteurs passent en revue quelques-unes des principales données de la littérature, en particulier celles qui concernent les aspects chronobiologiques de la dépression. Les investigations sophistiquées réalisées dans les unités de recherche peuvent avoir certaines conséquences cliniques et pratiques qui sont également évoquées. En effet, une évaluation clinique soigneuse, orientée sur des bases chronobiologiques suffit bien souvent à proposer des traitements individuels assez simples. Parmi ceux-ci, la privation partielle de sommeil (PPS) représente un moyen utile, permettant une amélioration rapide, mais malheureusement souvent imprévisible et transitoire, des troubles de l’humeur. Il semble possible de rendre plus fiables les PPS grâce à des interventions sur la température, la prise de nourriture et l’exposition à la lumiére.

De plus, les auteurs décrivent un moyen possible de pérenniser les effets antidépresseurs de la PPS par des «microprivations de sommeil» réalisées pendant 15 min, à un moment spécifique de la nuit. Les résultats concernant 11 patients déprimés graves soumis à cette méthode sont exposés, 7 de ces sujets étant maintenus depuis 6 à 20 mois dans un état euthymique.

Summary

Summary

Considering the literature, depression appears to be a major field for biological research and has already provided a number of «objective diagnostic criteria» and chronobiological theories. By contrast, the therapeutic impact of these approaches is most often limited to some specialized ciinics where areactive depressed patients are ultimately referred.

In this paper, we shall review some of the data in the literature concerning the chronobiological aspects of depression and give some counterparts to the sophisticated investigations performed in research boards. When carefully Performed and orientated, this clinical approach is often sufficient to propose radier simple treatments to a given Patient. Among these treatments, partial sleep deprivation (PSD) represents a useful toot with rapid but iintil now short lasting and rather unpredictable antidepressant effects. An improvement of PSD effects can, however, be obtained through interventions on temperature, food and light.

We shall describe a method we are investigating which is aimed at maintaining the antidepressant effects of sleep deprivation through «sleep microprivations» performed during 15 min at a specifie moment of the night. The data from 11 patients treated according to this technique will also be reported, togetlier with the management of seasonal affective disorders with bright light exposure.

Keywords

dépressionchronobiologielumièretempératureprivation de sommeildepressionchronobiologylight therapytemperaturesleep deprivation
Type
Article original
Information
Psychiatry and Psychobiology , Volume 3 , Issue 1 , 1988 , pp. 11 - 18
Copyright
Copyright © European Psychiatric Association 1988

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