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Research Article| Volume 20, ISSUE 2, P135-145, February 1985

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“Paradoxical” shortening of REM latency on first recording night in major depressive disorder: Clinical and polysomnographic correlates

  • Marc Ansseau
    Footnotes
    Affiliations
    From the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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  • David J. Kupfer
    Correspondence
    Address reprint request to: David J. Kupter, M.D, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213 USA
    Footnotes
    Affiliations
    From the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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  • Charles F. Reynolds III
    Footnotes
    Affiliations
    From the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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  • Patricia A. Coble
    Footnotes
    Affiliations
    From the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
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  • Author Footnotes
    1 Present address: Psychopharmacology Unit, University Hospital de Bavieŕe, B-4020 Liège, Belgium.
    2 Our gratitude is due to Dr. V. Grochocinski for her generous assistance in data management, to A.B. McEachran, who performed the data analysis, and to K. Slomka and B. Bradbury for their technical assistance.
DOI:https://doi.org/10.1016/0006-3223(85)90073-3
“Paradoxical” shortening of REM latency on first recording night in major depressive disorder: Clinical and polysomnographic correlates
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      Abstract

      Among 92 inpatients with major depressive disorders, variability in REM latency (RL) during the first two recording nights was assessed by means of an “adaptation coefficient” (AC = night 1 RL — night 2 RL × 100 ÷ mean RL for nights 1 and 2). Although mean RL was very similar for both nights (48.1 and 50.7 min), individual ACs showed a gaussian distribution [range: −176.5–171.4; mean: −1.2 (67.3); median: −4.4]. Forty-two patients (45.7%) exhibited shortening of RL on night 2 compared with night 1 (positive AC, corresponding to an “expected” evolution), 48 patients (52.2%) displayed the opposite pattern (negative AC, corresponding to a “paradoxical” evolution), and two patients had identical values on both nights. Extent of increase in RL from first to second night (i.e., extent of “paradoxical” evolution) correlated significantly with increasing duration of current episode, earlier age of onset, and poorer clinical response to tricyclic antidepressants. A cutoff AC of −7 correctly classified 62% of patients according to treatment response. The research diagnostic criteria-based retarded subtype of depression was associated with a more negative AC (i.e., a more “paradoxical” evolution), and the situational subtype was associated with a more positive AC (i.e., a more “expected” evolution) than the remainder of the sample. The subgroup with the most negative ACs (i.e., largest increases in RL from first to second night) also had longer sleep latencies, whereas the subgroup with the most positive ACs (i.e., largest decreases in RL) had higher REM activity and REM density as compared with the remainder of the sample. These results suggest that RL in major depression is not a static parameter and that the study of its within-subject variability can be helpful for diagnostic confirmation and prediction of treatment response.
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      Article info

      Publication history

      Received in revised form: August 1, 1984
      Received: June 17, 1984

      Footnotes

      ☆Supported in part by National Institute of Mental Health grants MH 24652, 30915, 37869, and 00295 and by a grant from the John D. and Catherine T. MacArthur Foundation Research Network on the Psychobiology of Depression.

      Identification

      DOI: https://doi.org/10.1016/0006-3223(85)90073-3

      Copyright

      © 1985 Published by Elsevier Inc.

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