BIOL PSYCHIATRY 1990;28:161-164
161
BRIEF REPORTS
REM Latency in Psychotically Depressed Adolescents Michael W. Naylor, Benjamin N. Shain, and James E. S.hipley
Introduction
subtype of depression (psychotic versus nonpsychotic) and REM latency in adolescents. We hypothesized that psychotically depressed adolescents would have shorter REM latencies than depressed adolescents without psychosis.
Major depression in adults is accompanied by characteristic polysoamographic abnormalities, including shorter latency to rapid eye movement (REM) sleep, less slow wave sleep, impaired sleep continuity, greater REM activity (especially in the first REM period), and elevated REM density compared with nondepressed age- Methods matched controls (Kupfer et al. 1978). Thase et The subjects were 12 unipolar depressed adoal. (1986) demonstrated that REM latency may lescents admitted to the University of Michigan be dependent upon depressive subtype. In their Adolescent Psychiatry Unit, Informed consent study, psychotically depressed subjects had sig- was obtained° The sample included 5 boys and ~ficantly shorter REM latencies than depressed 7 girls ages 13.4-17.0 years (mean = 15.6 patients without psychotic features. Sleep onset years). Diagnoses were made according to Re•REM periods were frequently seen in their pop- search Diagnostic Criteria (Spitzer et al. 1978) based on information obtained from a semistrucul~.tion of psychotically depressed adults. Studies of REM latency in depressed ado- tured interview, the Schedule for Affective Dislescents here been inconclusive. Goetz et al. orders and Schizophrenia (Endicott and Spitzer (1987) and Appelboom-Fondu et al. (1988) failed 1978). Depression severity was measured with to find short REM latency in depressed adoles- the Hamilton Rating Scale for Depression (HRSD) cents compared with normal controls. In con- (Hamilton 1960) and the Children's Depression ~rast, Lahmeyer et al. (1983) and Emslie et al. Rating Scale---Revised (CDRS-R) (Poznanski (1988) found that depressed adolescents had et al. 1984), All patients were observed psy~o~er ~_~M !atencies than age-matched normal chotropic medication free in the hospital for 2 controls. None of these studies compared REM weeks prior to the study. Only those who resleep in psychotically and nonpsychotically de- mained depressed throughout the observation pressed adolescents. We undertook this prelim- period were included in the study. Patients were inary study to examine t~e relationship between studied polysomnographically from their own beds for 2 nights using an electroencephalogram (EEG) sleep telemetry system. The ~tudies were performed as described previously (Grunhnus et From the University of Michigan, Department of Psychiatry, C~ild and Adolescent Psychiatric Hospital (M.W.N., B.N.S.) and the al. 1988). All polygraph records were scored Sleep Diagnostic and Research Program (M.W.N., J.E.S.) Address repi~tnt~cques~ to ,MichaelW. N~y!or, M.D., Depm_r~_ent visu~y on_the basis of l-rain epochs according Cf Psychiatry, Box 0706, 1500 E. Medical Center Drive, Ann to Rechtsehaffen-Kales et al. (1968) criteria by &~bor, l ~ ~3139-0706. experienced technicians blind to patient diagReceived November 30, 1989; revised February 3, 1990. © 1990 Society of Biological Psychiatry
0006-3223/90/$03.50
162
Brief Reports
BIOL PSYCHIATRY 1990;28:161-164
Table 1. Sleep Variables in Depressed Adolescents with and Without Psychotic Features (Mean _ SD) Psychotic Nonpsychotic (n = 5)
(n = 7)
p
161
BRIEF REPORTS
REM Latency in Psychotically Depressed Adolescents Michael W. Naylor, Benjamin N. Shain, and James E. S.hipley
Introduction
subtype of depression (psychotic versus nonpsychotic) and REM latency in adolescents. We hypothesized that psychotically depressed adolescents would have shorter REM latencies than depressed adolescents without psychosis.
Major depression in adults is accompanied by characteristic polysoamographic abnormalities, including shorter latency to rapid eye movement (REM) sleep, less slow wave sleep, impaired sleep continuity, greater REM activity (especially in the first REM period), and elevated REM density compared with nondepressed age- Methods matched controls (Kupfer et al. 1978). Thase et The subjects were 12 unipolar depressed adoal. (1986) demonstrated that REM latency may lescents admitted to the University of Michigan be dependent upon depressive subtype. In their Adolescent Psychiatry Unit, Informed consent study, psychotically depressed subjects had sig- was obtained° The sample included 5 boys and ~ficantly shorter REM latencies than depressed 7 girls ages 13.4-17.0 years (mean = 15.6 patients without psychotic features. Sleep onset years). Diagnoses were made according to Re•REM periods were frequently seen in their pop- search Diagnostic Criteria (Spitzer et al. 1978) based on information obtained from a semistrucul~.tion of psychotically depressed adults. Studies of REM latency in depressed ado- tured interview, the Schedule for Affective Dislescents here been inconclusive. Goetz et al. orders and Schizophrenia (Endicott and Spitzer (1987) and Appelboom-Fondu et al. (1988) failed 1978). Depression severity was measured with to find short REM latency in depressed adoles- the Hamilton Rating Scale for Depression (HRSD) cents compared with normal controls. In con- (Hamilton 1960) and the Children's Depression ~rast, Lahmeyer et al. (1983) and Emslie et al. Rating Scale---Revised (CDRS-R) (Poznanski (1988) found that depressed adolescents had et al. 1984), All patients were observed psy~o~er ~_~M !atencies than age-matched normal chotropic medication free in the hospital for 2 controls. None of these studies compared REM weeks prior to the study. Only those who resleep in psychotically and nonpsychotically de- mained depressed throughout the observation pressed adolescents. We undertook this prelim- period were included in the study. Patients were inary study to examine t~e relationship between studied polysomnographically from their own beds for 2 nights using an electroencephalogram (EEG) sleep telemetry system. The ~tudies were performed as described previously (Grunhnus et From the University of Michigan, Department of Psychiatry, C~ild and Adolescent Psychiatric Hospital (M.W.N., B.N.S.) and the al. 1988). All polygraph records were scored Sleep Diagnostic and Research Program (M.W.N., J.E.S.) Address repi~tnt~cques~ to ,MichaelW. N~y!or, M.D., Depm_r~_ent visu~y on_the basis of l-rain epochs according Cf Psychiatry, Box 0706, 1500 E. Medical Center Drive, Ann to Rechtsehaffen-Kales et al. (1968) criteria by &~bor, l ~ ~3139-0706. experienced technicians blind to patient diagReceived November 30, 1989; revised February 3, 1990. © 1990 Society of Biological Psychiatry
0006-3223/90/$03.50
162
Brief Reports
BIOL PSYCHIATRY 1990;28:161-164
Table 1. Sleep Variables in Depressed Adolescents with and Without Psychotic Features (Mean _ SD) Psychotic Nonpsychotic (n = 5)
(n = 7)
p
