A 6-day combined wake and light therapy trial for unipolar depression.

BACKGROUND: There are a dozen studies on double or triple chronotherapy in depression (sleep deprivation [wake therapy] + light therapy + sleep advance/stabilization). We investigated efficacy and feasibility of a modified triple chronotherapy protocol. METHODS: Thirty-five hospitalized patients with moderately severe non-seasonal depressive disorder, mostly free from antidepressants, underwent a 6-day protocol consisting of partial sleep deprivation late in the second half of the night (from 4:00 to 8:00) in a light therapy room (blue-enhanced white light increased hourly from 600→1300→2200→2800 lx) alternating with recovery nights with morning light treatment from 7:00 to 8:00. Patients were randomized to wear glasses with no filter (clear, N = 19) or filtering blue wavelength (orange-appearance, light intensity diminution by ∼70%, N = 16) during the treatments. Sleep was targeted to be shifted at least 1 h earlier. Depression was scored using HDRS-17 (Hamilton Depression Rating Scale) and BDI-II (Beck Depression Inventory-II) - before and after the 6-days treatment, HDRS-6-SR - daily, and visual analogue scales (VAS) for mood and energy - several times every day. RESULTS: Depression levels significantly declined following the first night and after 6-days treatment, with no difference between white and orange lights. Nevertheless, some superiority of white light emerged with respect to response rate (mood VAS), immediate effect during the 4-h treatment sessions (energy VAS), and expected treatment outcomes. All patients successfully advanced bedtime/wake-up (by 30-40 minutes) and resisted naps during daytime. LIMITATIONS: Relatively small sample size. CONCLUSIONS: The modified triple chronotherapy was well tolerated and improved depression. Light spectrum/intensity plays some role in the response.

The polymorphism of dopamine receptor D4 (DRD4) and dopamine transporter (DAT) genes in the men with antisocial behaviour and mixed martial arts fighters.

Objectives: Variable-number tandem repeat (VNTR) polymorphisms of DRD4 and DAT genes were studied in the Russian and Chechen men convicted of crimes, and two control groups comprised of the MMA fighters and a sample of general population. A group of MMA fighters included only the subjects without history of antisocial behaviour. Methods: DNA was isolated by phenol-chloroform extraction from the blood. Genotyping VNTR polymorphisms of the DRD4 and DAT genes were performed by PCR on published methods. Results: Among those convicted of felonies and most grave crimes, carriers of DRD4 long alleles are found more frequently, similarly to the cohort of MMA fighters (lacking criminal record in both paternal lines). The 9/9 DAT genotype carriers are more frequently encountered among the habitual offenders. A frequency of the combination of the DRD4 genotype 4/7 and DAT genotype 10/10 is clearly higher among the convicts of violent crimes and the MMA fighters. One can speculate the presence of a 'controlled aggression' without a predisposition to pathological violence in the MMA fighters. Conclusions: Our study supports the hypothesis of genetic predisposition to different variants of extreme behaviour mediated by genetic determinants involved in the functioning of neuromediator systems including those controlling dopamine pathways.

Polymorphism of serotonin transporter gene in male subjects with antisocial behavior and MMA fighters.

In our study, the frequencies of serotonin transporter gene (5-HTT) polymorphisms and their combinations are compared in the healthy male subjects with antisocial behavior, in general, and in those with its particular forms, as well as in the reference group of MMA fighters. Subjects convicted of unlawful actions were classified into those convicted of violent crimes or non-violent ones. The group of subjects convicted of violent crimes was further subdivided into those convicted of murder, or robbery, or of inflicting grave body injuries. The group of MMA fighters was selected from the subjects without a prior history of antisocial behavior or criminal record in the subjects or their relatives. The frequency of D allele in the groups of convicted subjects and MMA fighters was higher, than in the population sample. Furthermore, the frequencies of D/D and 12/12 genotype combinations were shown to be higher in the group of convicted subjects, especially, in habitual criminals and those convicted of grave crimes or murder. The predisposition of MMA fighters to violent behavior and physical aggressive suppression of an opponent is successfully implemented in their professional career; however, this behavioral pattern appears to represent the controlled aggression.

Impact of long-term meditation practice on cardiovascular reactivity during perception and reappraisal of affective images.

Meditation has been found to be an efficient strategy for coping with stress in healthy individuals and in patients with psychosomatic disorders. The main objective of the present study was to investigate the psychophysiological mechanisms of beneficial effects of meditation on cardiovascular reactivity. We examined effects of long-term Sahaja Yoga meditation on cardiovascular reactivity during affective image processing under "unregulated" and "emotion regulation" conditions. Twenty two experienced meditators and 20 control subjects participated in the study. Under "unregulated" conditions participants were shown neutral and affective images and were asked to attend to them. Under "emotion regulation" conditions they down-regulated negative affect through reappraisal of negative images or up-regulated positive affect through reappraisal of positive images. Under "unregulated" conditions while anticipating upcoming images meditators vs. controls did not show larger pre-stimulus total peripheral resistance and greater cardiac output for negative images in comparison with neutral and positive ones. Control subjects showed TPR decrease for negative images only when they consciously intended to reappraise them (i.e. in the "emotion regulation" condition). Both meditators and controls showed comparable cardiovascular reactivity during perception of positive stimuli, whereas up-regulating of positive affect was associated with more pronounced cardiac activation in meditators. The findings provide some insight into understanding the beneficial influence of meditation on top-down control of emotion and cardiovascular reactivity.