Chronotherapy Network Netherlands (CNN)

Information is provided about the Chronotherapy Network Netherlands (CNN)

Chronotherapeutische interventies

De effecten van het natuurlijk dag-en-nachtritme van de mens in zijn leefomgeving mogen zich in toenemende aandacht verheugen. Biologische, psychologische en sociaalmaatschappelijke factoren spelen daarbij een rol. Verstoringen van dat ritme kunnen tot diverse klachten leiden zoals onder andere slaapproblemen en depressies. Het beïnvloeden van de biologische ritmes door middel van chronotherapie (o.a. waaktherapie, lichttherapie en sociaalritmetherapie) blijkt in toenemende mate een effectieve manier van behandelen. In dit artikel worden deze interventies besproken

Chronotherapeutic interventions

De effecten van het natuurlijk dag-en-nachtritme van de mens in zijn leefomgeving mogen zich in toenemende aandacht verheugen. Biologische, psychologische en sociaalmaatschappelijke factoren spelen daarbij een rol. Verstoringen van dat ritme kunnen tot diverse klachten leiden zoals onder andere slaapproblemen en depressies. Het beïnvloeden van de biologische ritmes door middel van chronotherapie (o.a. waaktherapie, lichttherapie en sociaalritmetherapie) blijkt in toenemende mate een effectieve manier van behandelen. In dit artikel worden deze interventies besproken

MMSE Changes During and After ECT in Late-Life Depression: A Prospective Study

OBJECTIVE: There is ongoing concern about the impact of electroconvulsive therapy (ECT) on cognition in patients with late-life depression (LLD), especially in patients for whom pretreatment Mini-Mental State Exam (MMSE) scores are low. Our aim was to examine the evolution of cognitive effects of ECT, using the MMSE in a large group of patients with LLD. METHODS: One hundred nine patients aged 55 years and older with unipolar depression, referred for ECT, were included in our study. The MMSE was assessed before, during, immediately after, and 6 months after ECT. RESULTS: MMSE scores improved significantly during the course of ECT and remained stable during the 6-month period after ending ECT for the total group. In the group of patients with a low MMSE score (<24) at baseline, the MMSE score improved significantly during ECT, whereas in the group of patients with a normal MMSE score (≥24) at baseline, the score did not change significantly during ECT. In both groups, MMSE scores still increased slightly after ECT was discontinued. CONCLUSION: ECT does not cause deleterious cognitive effects, as measured with the MMSE, during and for 6 months after the ECT course in patients with LLD. In the event of a baseline cognitive impairment, MMSE scores tend to improve significantly during and for 6 months after the ECT course. The presence of pretreatment cognitive impairment should not lead clinicians to withhold ECT in older patients with severe depression.status: publishe

Long-term outcome following electroconvulsive therapy for late-life depression : five-year follow- up data from the MODECT study

Objective: Electroconvulsive therapy (ECT) is the most effective treatment for late-life depression (LLD). Research addressing long-term outcome following an acute course of ECT for LLD is limited. We aimed to describe relapse, cognitive impairment and survival 5 years after a treatment with ECT for severe LLD, and assess the association of clinical characteristics with all three outcome measures. Methods: This cohort study was part of the Mood Disorders in Elderly treated with ECT (MODECT) study, which included patients aged 55 years and older with major depressive disorder. Data regarding clinical course, cognitive impairment and mortality were collected 5 years after the index ECT course. We used multivariable Cox proportional hazards models and logistic regression models to assess the association of clinical characteristics with relapse and survival, and cognitive impairment, respectively. Results: We studied 110 patients with a mean age of 72.9 years. 67.1% of patients who showed response at the end of the index ECT course relapsed, and the included clinical characteristics were not significantly associated with the risk of relapse. 38.8% of patients with available data showed cognitive impairment at five-year follow-up. 27.5% were deceased; higher age and a higher number of previous psychiatric admissions were significantly associated with increased risk of mortality. Conclusions: Five-year outcome after a course of ECT for severe LLD seems to be in line with long-term outcome following other acute treatments for severe LLD in terms of relapse, cognitive impairment and survival. Additional studies aimed at improving long-term outcome in severe LLD are warranted