Hierbij geven wij u enige suggesties met betrekking tot literatuur op het gebied van klinische chronotherapie. Van de vrij verkrijgbare literatuur geven we tevens de link naar het betreffende artikel.
Overzichtsartikel
Achtergrond
In de literatuur is er toenemend aandacht voor de chronobiologie van stemmingsstoornissen en de daarop gebaseerde chronotherapiën. Doel: Bespreken van de achtergronden en indicaties van de belangrijkste chronotherapiën bij stemmingsstoornissen.
Methode
Beknopt literatuuronderzoek naar chronotherapie bij stemmingsstoornissen met PubMed en bestudering van standaardwerken.
Resultaten
Lichttherapie is de best onderzochte vorm van chronotherapie. Chronotherapiënt lijken in kleine open studies veelbelovend, maar gerandomiseerde dubbelblinde onderzoeken ontbreken nog.
Conclusie
De chronobiologie verschaft niet alleen een nieuw neurobiologisch model, het biedt ook een aantal veelbelovende of mogelijk effectieve niet-farmacologische therapieën voor met name stemmingsstoornissen. Lichttherapie heeft een plaats verdiend in de multidisciplinaire richtlijnen. Verder is meer, beter en groter onderzoek nodig naar de diverse chronotherapieën.
Tijdschrift voor psychiatrie 54(2012)6, 527-537
The field of chronobiology has vastly expanded over the past few decades, bringing together research from the fields of circadian rhythms and sleep. The importance of the envi¬ronmental day–night cycle on our health is becoming increasingly evident as we evolve into a 24-hour society. Reducing or changing sleep times against our natural instincts to rest at night has a detrimental impact on our well-being. The mammalian circadian clock, termed “the suprachiasmatic nucleus”, is responsible for synchronizing our behavioral and physiological outputs to the environment. It utilizes light transcoded by specialized retinal photoreceptors as its cue to set internal rhythms to be in phase with the light–dark cycle. Misalignment of these outputs results in symptoms such as altered/disturbed sleep patterns, changes in mood, and physical and mental exhaustion – symptoms shared by many affective clinical disorders. Key links to circadian abnormalities have been found in a number of disorders, such as seasonal affective disorder, nonseasonal depression, and bipolar affective disorder. Furthermore, therapies developed through chronobiological research have been shown to be beneficial in the treatment of these conditions. In this article, we discuss the impact of circadian research on the manage¬ment of affective disorders, giving evidence of how a misaligned circadian system may be a contributor to the symptoms of depression and how moderating circadian rhythms with light therapy benefits patients.
ChronoPhysiology and Therapy 2014:4 79–85
‘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.
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Ybe Meesters,1 Marijke CM Gordijn,2,3
1University Center for Psychiatry, University Medical Center Groningen, 2Department of Chronobiology, GeLifes, University of Groningen, Groningen, the Netherlands; 3Chrono@Work B.V., Groningen, the Netherlands
Abstract: Seasonal affective disorder (SAD), winter type, is a seasonal pattern of recurrent major depressive episodes most commonly occurring in autumn or winter and remitting in spring/summer. The syndrome has been well-known for more than three decades, with light treatment being the treatment of first choice. In this paper, an overview is presented of the present insights in SAD. Description of the syndrome, etiology, and treatment options are mentioned. Apart from light treatment, medication and psychotherapy are other treatment options. The predictable, repetitive nature of the syndrome makes it possible to discuss preventive treatment options. Furthermore, critical views on the concept of SAD as a distinct diagnosis are discussed.
https://doi.org/10.2147/PRBM.S114906
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