COMORBIDITY OF NON-24-HOUR SLEEP-WAKE SYNDROME AND SEASONAL AFFECTIVE DISORDER IN A YOUNG MAN: A CASE REPORT

摘要

Objective: Few clinical reports have described in detail the comorbidity of seasonal affective disorder (SAD) and non-24-hour sleep-wake syndrome (non-24-SW). Both SAD and non-24-SW are thought to be caused by the interplay between internal clock dysfunction and insufficient external time cues. The aim of this study is to present and discuss in detail a subtype of psychiatric comorbidity and its sleep-focused intervention. Method: Report of a single case. Results: The patient was a 20-year old Asian man. During adolescence, he had experienced recurrent depressive episodes in the winter, which forced him to quit high school. From his case history he appeared to meet the criteria for SAD, and his sleep-wake diary clearly indicated a typical case of non-24-SW. Treatment comprised medication and sleep hygiene strategies as well as bright light therapy for preventive purposes. This sleep-focused intervention was clinically effective in both the acute and maintenance phases. Conclusions: Better awareness of such psychiatric comorbidity may help to increase the recognition of treatable sleep-wake schedule disruptions. Clinicians should pay more attention to the chronobiological aspect of a patients condition since adolescence.