Alternative Treatments for Premenstrual Dysphoric Disorder

经前焦虑症的替代治疗

基本信息

批准号：
9267940
负责人：
BARBARA L PARRY
金额：
$ 35.78万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-05-01 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9267940
关键词：
Adverse effects Affect Antidepressive Agents Behavior Therapy Biological Rhythm Biology Chronic Chronotherapy Circadian Rhythms Combined Modality Therapy Crossover Design DSM-IV Depressive disorder Development Disease Family Health Impairment Intervention Left Light Link Luteal Phase Major Depressive Disorder Malignant neoplasm of ovary Measures Melatonin Menopause Menstrual cycle Mental Depression Mood Disorders Moods Outcome Outcome Measure Patients Periodicity Pharmaceutical Preparations Pharmacological Treatment Pharmacology Phase Phototherapy Postpartum Period Pregnancy Randomized Relapse Risk Safety Selective Serotonin Reuptake Inhibitor Sleep Symptoms Testing Time Translating Unipolar Depression Wakefulness Woman Women&apos s Health Work alternative treatment antepartum depression antidepressant effect base efficacy testing improved innovation intervention effect malignant breast neoplasm multimodality novel premenstrual dysphoric disorder prevent randomized trial response sleep onset treatment effect treatment response urinary

项目摘要

Innovative, alternative treatments are needed for Premenstrual Dysphoric Disorder (PMDD), a disabling depressive disorder listed in DSM-IV, affecting 5-8% of menstruating women. Left untreated, PMDD can progress to major depression. Offered medication, at least 40% of women do not respond, develop problematic side-effects or seek options other than chronic pharmacological treatment for this periodic illness. Previously we independently administered sleep and light behavioral therapies, translating discoveries from basic circadian biology to improve the health of women with PMDD. In response to a call for the development of novel combination therapies, in this proposal we plan to co-administer wake therapy followed by light treatment, a novel alternative approach, never before tried in PMDD, despite its demonstrated efficacy in other mood disorders. These potentially complementary treatments have the advantage of wake therapy hastening the onset of the antidepressant effects of light treatment, a crucial benefit during the relatively short-lived symptoms of the 2-week luteal phase, whereas light treatment maintains the benefit of the otherwise transitory effects of wake therapy often lost after subsequent sleep. Our primary aim is to examine the effects of these interventions on mood, and secondarily on circadian rhythms, to test the hypothesis that critically-timed chronotherapy improves mood by correcting phase disturbances in melatonin and sleep. As we found that in PMDD melatonin rhythms were phase-delayed (shifted-later) in the symptomatic luteal compared with the asymptomatic follicular, menstrual cycle phase, we hypothesize that advancing melatonin rhythms with late wake therapy (LWT: sleep 21:00-01:00 h, followed by wake) plus morning bright white light (BWL) will improve mood in PMDD patients more than delaying them with early wake therapy (EWT: wake, then sleep 03:00-07:00 h) plus evening BWL. Outcome measures are mood, urinary melatonin, sleep/activity in PMDD subjects. These studies will determine whether innovative, alternative, combined chronobiological interventions, targeted to specific underlying circadian rhythm abnormalities, can benefit mood in PMDD. The results may impact other depressive disorders with chronobiological disturbances and other women�s mood disorders.

经性交障碍（PMDD）需要创新的替代治疗，这是一种在DSM-IV中列出的残疾抑郁症，影响5-8％的月经女性。剩下的未经治疗，PMDD可以发展为重度抑郁症。提供药物，至少有40％的女性没有反应，发展有问题的副作用或寻求这种定期疾病的慢性药物治疗以外的其他选择。以前，我们独立地管理睡眠和轻度行为疗法，将基本昼夜节律生物学的发现转化为改善PMDD女性的健康。为了响应呼吁开发新型组合疗法的呼吁，在此提案中，我们计划共同管理唤醒疗法，然后进行轻疗法，这是一种新型的替代方法，从未在PMDD中尝试过，dospite在其他情绪障碍中证明了其效率。这些潜在的完整疗法具有唤醒治疗的优势，这加快了光治疗的抗抑郁作用的发作，这是2周黄体阶段相对短暂的症状的关键益处，而光治疗则保持了尾流治疗后的临时效果的益处，经常在后续睡眠后失去。我们的主要目的是检查这些干预措施对情绪的影响，以及继发于昼夜节律的影响，以检验以下假设，即通过纠正褪黑激素和睡眠的相位障碍来改善批判时间的年度疗法可改善情绪。 As we found that in PMDD melatonin rhythms were phase-delayed (shifted-later) in the symptomatic luteal compared with the asymmetric follicular, menstrual cycle phase, we hypothesize that advancing melatonin rhythms with late wake therapy (LWT: sleep 21:00-01:00 h, followed by wake) plus morning bright white light (BWL) will improve mood in PMDD patients more than通过早期唤醒疗法延迟它们（ewt：唤醒，然后睡觉03：00-07：00 h）加上晚上BWL。结果指标是情绪，尿褪黑激素，PMDD受试者的睡眠/活动。这些研究将确定针对特定潜在的昼夜节律异常的创新，替代性，共同生物学干预措施是否可以使PMDD中的情绪受益。结果可能会影响其他时间生物学疾病和其他女性情绪障碍的其他抑郁症。