Depression Disturbance Research Articles

Hyperactivation of the habenula as a link between depression and sleep disturbance

Depression occurs frequently with sleep disturbance such as insomnia. Sleep in depression is associated with disinhibition of the rapid eye movement (REM) sleep. Despite the coincidence of the depression and sleep disturbance, neural substrate for depressive behaviors and sleep regulation remains unknown. Habenula is an epithalamic structure regulating the activities of monoaminergic neurons in the brain stem. Since the imaging studies showed blood flow increase in the habenula of depressive patients, hyperactivation of the habenula has been implicated in the pathophysiology of the depression. Recent electrophysiological studies reported a novel role of the habenular structure in regulation of REM sleep. In this article, we propose possible cellular mechanisms which could elicit the hyperactivation of the habenular neurons and a hypothesis that dysfunction in the habenular circuit causes the behavioral and sleep disturbance in depression. Analysis of the animals with hyperactivated habenula would open the door to understand roles of the habenula in the heterogeneous symptoms such as reduced motor behavior and altered REM sleep in depression.

D<sub>1</sub> and TrkB Receptors Take Charge of the Molecular Antidepressant Action in Cultured Astroglial Cells

In psychopharmacology of depression, we observe two ways of research. One group is focused on catecholamines action. Second one fixes attention on neuronal morphogenesis and synaptic plasticity. The intimate connection of astrocytes, neurons and synaptic endings determines glial participation in neural homeostasis. Consequently this situation enlarges the role of astrocytes in the CNS synaptic plasticity. Brain Derived Neurotrophic factor and its receptor TrkB suppose to coordinate both of the above mentioning signaling pathways in depression disturbances. In our experiment, we have exploited striatal tissue because in our opinion this structure is misjudged in pathophysiology of depression alas; Several hypothesis proposed striatum as important in future intention activity structure. RT-PCR analysis was used to determine D1, BDNF and TrkB mRNA expression in cultured striatal astroglial cells. Administration of three representative antidepressants (ADs) like amitriptyline, moclobemide and sertraline to astroglial culture medium increase the D1, BDNF/TrkB mRNA expression. Our previous study showed that the stimulation of cAMP to CREB pathway after D1 receptors excitation constituted a common response to ADs. The present results signify that D1, BDNF/TrkB link which is next neural track (after cAMP/PKA) involved in the CNS adaptation to external conditions altered by chronic ADs treatment. Moreover, the striatum tissue appears to be important formation which takes an active part in antidepressant action thus essential in depression disorder etiology.

Comment on Lara Rzesnitzek (2013) “Early Psychosis” as a mirror of biologist controversies in post-war German, Anglo-Saxon, and Soviet Psychiatry

Comment on Lara Rzesnitzek (2013) “Early Psychosis” as a mirror of biologist controversies in post-war German, Anglo-Saxon, and Soviet Psychiatry

持续泵入咪达唑仑及积极医护干预治疗小儿癫痫持续状态疗效研究

目的：研究咪达唑仑持续静脉泵入治疗小儿癫痫持续状态的临床疗效，同时探讨积极的医护干预对于控制感染、意识障碍及呼吸抑制等不良反应的疗效。方法：选取2011年12月~2012年10月收入院的癫痫持续状态(SE)患儿90例为观察对象，随机分为两组：治疗组46例，给予咪达唑仑持续静脉泵入，并将46例患儿随机分为两组，每组均为23例患儿，一组给予积极医护干预，另一组给予常规的医疗护理；对照组44例，仅应用传统的一线抗癫痫药物(AEDs)治疗，同样将44例患儿随机分为两组，每组均为22例患儿，一组给予积极医护干预，另一组给予常规的医疗护理，最后将两组疗效进行对照研究，并比较两种不同医护干预产生不良反应的发生概率，组间比较，最后行统计学处理。结果：治疗组治疗有效率明显高于对照组(P Objective: To study the clinical curative effect of the midazolam pump into vein for treating children with status epilepticus, and discuss the curative effect of the positive medical intervention to control adverse reactions such as infection, disturbance of consciousness and respiratory depression. Methods: 90 cases of status epilepticus (SE) children, who were admitted between December 2011-October 2012 as observation objects, were randomly divided into two groups: treatment group (46 cases) was given midazolam continuous intravenous pumping, and the 46 cases were randomly divided into two groups: each group composed of 23 cases, one group being given positive medical intervention, and the other group being given regular medical care; control group that has 44 cases, which were only given the traditional first-line antiepileptic drugs (AEDs) treatment, and they were randomly divided into two groups: each group composed of 22 cases, one group being given positive medical intervention, and the other group being given regular medical care. Finally, the curative effect between the two groups and the two different medical interventions in the probability of the occurrence of adverse reactions were compared. At last, comparing between groups, we made good use of the statistical soft ware to deal with the data. Result: The response rate of the efficient treatment group was obviously higher than that of the control group (P < 0.05), the treatment group of midazolam is safe and effective dosage is 0.1 to 0.5 mg/(kg·h), the positive incidence of adverse reactions (15.2%) of the medical intervention group was obviously lower than that of the control group patients (P < 0.05). Conclusions: The continuous intravenous drip of midazolam is a safe and effective control of the treatment of children with status epilepticus, and positive health care intervention can significantly reduce the incidence of infection, and adverse reactions such as disturbance of consciousness, and can be popularized.

P05.07. Chronic Fatigue, Depression, and Sleep Disturbances in a 20-year-old Male Collegiate Basketball Player: A Case Report

Focus Areas: Integrative Approaches to Care, Mental HealthChronic fatigue and depression are 2 symptoms that are increasing in frequency in the offices of physicians. Many of these individuals need obvious dietary and lifestyle changes as primary management. In contrast, this case report illustrates a 20-year-old male collegiate basketball player suffering from chronic fatigue, depression, and abnormal sleep patterns. This patient was being treated by a specialty physician group with the diagnoses of chronic fatigue syndrome and overtraining syndrome. The patient was under the care of the same physician group at the time of his initial visit to a chiropractic physician that specialized in functional medicine. Adrenal stress panel showed that the patient was in second-stage adrenal syndrome. Pathological gastrointestinal testing revealed Helicobacter pylori, Giardia, Entamoeba histolytica, and Cryptosporidium parvum infections. Heavy metal toxicity of lead and mercury also were present in this individual. Abnormal amino acid levels were seen when evaluating organic cation transporter (OCT2) status. In addition to changing to an ancestral diet and recommending a core multivitamin, antioxidant, and essential fatty acid supplementation, other personalized recommendations were given to the patient according to the results of the functional labs. The patient was given recommended specific dosages of DHEA, licorice root, pregnenlone to reduce adrenal syndrome; botanical antimicrobial and antiparasitic supplementation; additional nutrients and silymarin to reduce heavy metal toxicity; and a protocols of 5-HTP and tyrosine to restore proper OCT2 function to presynaptic nerves. After treatment, the patient experienced restoration of normal sleep patterns and elimination of his depression and chronic fatigue and was able to exercise and maintain a normal lifestyle. This case showed that uncommon patient populations can suffer from chronic fatigue secondary to subclinical infections regardless of apparent health status and also that functional analysis of the organ systems of adrenal, gastrointestinal, and detoxification can assist in complex cases.

81. Relationships of Toxoplasma gondii antibody titers and dysphoric moods in female veterans

A cross-sectional study of ethnically diverse female veterans (n = 53) was conducted. These veterans had a mean age of 49.8 years. A demographic scale and panel of psychosocial instruments were employed. Blood was drawn for inflammatory markers and Toxoplasma gondii titers. Chronic T. gondii infection has been associated with behavioral and mood changes in several populations, but has not been studied in veterans. Sixteen percent of this sample screened positive for PTSD and 20% for depression. T. gondii chronic infection, defined as a titer of 10 IU/ml or higher was present in 16% of the sample, and 5% had levels consistent with reactivation of this brain parasite (>200 IU/ml). The titers associated with chronic infection were correlated significantly with depression (p < .03), anger (p < .001) and total disturbance (p < .03). Women screening positive for depression and/or PTSD had four times higher titers than non-depressed women. In addition, T. gondii positive women reported significantly more experiences of military sexual trauma (p < .04). These data provide a snapshot of older women veterans with a 22% T. gondii infection rate. These women may have been exposed in the middle east where infection rate is much higher than in the US. This parasite localizes in the brain and may influence risk taking, reaction time, depression, schizophrenia and suicidality risk. The role of this organism in military related psychological and neurological sequelae deserves attention.

Neuropsychiatric Features of Parkinsonism Dementia Complex and Other Neurodegenerative Diseases on Guam (P05.040)

Objective: To assess the neuropsychiatric features of patients with neurodegenerative diseases on Guam. Background A unique clinical syndrome of amyotrophic lateral sclerosis/parkinsonism dementia complex (ALS/PDC) is seen in Guam but other neurodegenerative diseases are also present. Much of the focus has been on the cognitive aspects of these dementias, while it is now known that neuropsychiatric symptoms feature prominently in neurodegenerative disease. The Neuropsychiatric Inventory (NPI) assesses psychopathology in dementia patients by evaluating 12 neuropsychiatric disturbances commonly encountered in patients with dementia: delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and appetite and eating abnormalities. Our aim was to compare the neuropsychiatric symptoms of patients with PDC and those with non-PDC neurodegenerative disease. Design/Methods: We evaluated the neuropsychiatric symptoms of 28 consecutive patients with dementia on Guam using the NPI. We used Chi-square tests to compare NPI symptoms in patients with PDC vs. those with non-PDC neurodegenerative diseases. Results: Amongst the 28 patients with dementia and an NPI, 8 had PDC and 20 had another neurodegenerative disease: AD/vascular (8), AD (7), vascular dementia (1), dementia with Lewy bodies (2), and choreiform disorders (2). Comparing the NPI symptoms in patients with PDC vs. all other neurodegenerative disease combined revealed significant differences in incidence of depression (63% vs. 15%, respectively, p=0.02), appetite/eating abnormalities (62% vs. 15%, respectively, p=0.02), and night-time behavior disturbances (50% vs. 10%, respectively, p=0.04). Conclusions: Many neuropsychiatric symptoms were observed in PDC and in non-PDC neurodegenerative diseases on Guam. Depression, changes in eating habits and night-time behavior disturbances were significantly more common in PDC. These differences likely relate to the underlying anatomical alterations and pathophysiology in PDC. Neuropsychiatric symptoms are present in PDC and are distressful to patients and caregivers, further study is required. Disclosure: Dr. Tartaglia has nothing to disclose. Dr. Lee has nothing to disclose. Dr. Geschwind has received personal compensation for activities with Gerson Lehrman Group, Clinical Advisors, MedaCorp and Esai, Inc. as a consultant and/or speaker. Dr. Perry has nothing to disclose. Dr. Afaisen has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Wu has nothing to disclose. Dr. Rodriguez has nothing to disclose. Dr. Ketelle has nothing to disclose. Dr. Steele has nothing to disclose. Dr. Miller has received personal compensation for activities with Allon Therapeutics, Inc. and TauRx Therapeutics, Ltd. Dr. Miller has received research support from Novartis.

Bergamot (Citrus bergamia Risso et Poiteau) essential oil: Biological properties, cosmetic and medical use. A review

The present article reviews all aspects of the known pharmacological activities of bergamot essential oil (Citrus bergamia) and of its major phototoxic component bergapten (5-methoxypsoralen, 5-MOP) as well as their use in cosmetics and medicine. Photo-addition of 5-MOP to DNA induces a phototoxic reaction followed by significant increase of human skin pigmentation with a proved consistent protection of epidermal cell DNA against further exposure to ultraviolet light. This property was used in suntan products, but the potential risk of photocarcinogenis stopped the development of such compositions. Medical indications include phototherapy of dermatoses like psoriasis and vitiligo (photochemotherapy, PUVA). More recent studies were developed concerning the melatoninergic potential of bergapten and its potential use in depression and sleep disturbances as well as the capacity of 5-MOP to block potassium channels, a potential symptomatic treatment of multiple sclerosis in demyelinated nerves. The anti-inflammatory, antibacterial and antifungal properties of bergamot oil will also be described as well as the most recent studies on its protection against neuropathic pain in cancer.

Identifying major depression using whole-brain functional connectivity: a multivariate pattern analysis

Recent resting-state functional connectivity magnetic resonance imaging studies have shown significant group differences in several regions and networks between patients with major depressive disorder and healthy controls. The objective of the present study was to investigate the whole-brain resting-state functional connectivity patterns of depressed patients, which can be used to test the feasibility of identifying major depressive individuals from healthy controls. Multivariate pattern analysis was employed to classify 24 depressed patients from 29 demographically matched healthy volunteers. Permutation tests were used to assess classifier performance. The experimental results demonstrate that 94.3% (P < 0.0001) of subjects were correctly classified by leave-one-out cross-validation, including 100% identification of all patients. The majority of the most discriminating functional connections were located within or across the default mode network, affective network, visual cortical areas and cerebellum, thereby indicating that the disease-related resting-state network alterations may give rise to a portion of the complex of emotional and cognitive disturbances in major depression. Moreover, the amygdala, anterior cingulate cortex, parahippocampal gyrus and hippocampus, which exhibit high discriminative power in classification, may play important roles in the pathophysiology of this disorder. The current study may shed new light on the pathological mechanism of major depression and suggests that whole-brain resting-state functional connectivity magnetic resonance imaging may provide potential effective biomarkers for its clinical diagnosis.

Antidepressants and Sleep: Neurophysiology and Clinical Correlates

Introduction: Depression is a common disorder associated with significant disability and is a substantial burden on the individual, their relatives and friends, and on society as a whole. Sleep disturbances are key features of depressive symptomatology, with more than 80% of depressed patients complaining of poor quality sleep. Methods: The range of available antidepressants is here reviewed in relation to mechanisms of action and the evidence of sleep alteration in patients with depression. Results: The available treatments are largely effective but their use is compromised by poor tolerability and low adherence to treatment. It is also clear that currently used antidepressant agents tend to disrupt sleep architecture. Agomelatine, a novel antidepressant, has been found successful in treating depressed patients. Because of its dual mechanism of action on MT1 and MT2 melatonin receptors in the SCN and its 5-HT2c antagonist properties, agomelatine has been effective in improving both quality of sleep and mood in depressed patients. Conclusions: There is clinical and epidemiological evidence that sleep disturbances in depression constitute a risk factor for poor clinical outcomes. Specifically, insomnia complaints precede the onset and recurrence of depression. For this rea- son antidepressants with a faster onset of action, with less interferences on sleep architecture would be expected to bring larger numbers of depressed patients to full remission.

A hypnotherapy intervention for the treatment of anxiety in patients with cancer receiving palliative care

This pilot study aimed to assess the benefits of hypnotherapy in the management of anxiety and other symptoms, including depression and sleep disturbance, in palliative care patients with cancer. Eleven hospice patients received four sessions of hypnotherapy and completed the Hospital Anxiety and Depression Scale, the Edmonton Symptom Assessment System, and the Verran and Snyder-Halpern Scale at set time points. Wrist actigraphy also provided an objective assessment of sleep quality. After the second hypnotherapy session there was a statistically significant reduction in mean anxiety and symptom severity, but not in depression or sleep disturbance. After the fourth session there was a statistically significant reduction in all four patient-reported measures but not in actigraphy. These results offer evidence that hypnotherapy can reduce anxiety in palliative care patients, as well as improving sleep and the severity of psychological and physical symptoms. Further studies are needed to explore whether the observed benefits were a direct result of the hypnotherapy and how the intervention could most benefit this patient population.

Adjunctive Sleep Medications and Depression Outcome in the Treatment of Serotonin-Selective Reuptake Inhibitor Resistant Depression in Adolescents Study

In the Treatment of Resistant Depression in Adolescents, study participants who received medication for sleep had a lower response rate. This report sought to clarify this finding. Depressed adolescents who had not responded to a previous adequate serotonin-selective reuptake inhibitor (SSRI) trial were randomly assigned to another SSRI, venlafaxine, another SSRI+cognitive behavior therapy (CBT), or venlafaxine+CBT. Augmentation with sleep medication was permitted as clinically indicated. Youth who received trazodone were six times less likely to respond than those with no sleep medication (adjusted odds ratio [OR]=0.16, 95% confidence interval [CI]: 0.05-0.50, p=0.001) and were three times more likely to experience self-harm (OR=3.0, 95% CI: 1.1-7.9, p=0.03), even after adjusting for baseline differences associated with trazodone use. None (0/13) of those cotreated with trazodone and either paroxetine or fluoxetine responded. In contrast, those treated with other sleep medications had similar rates of response (60.0% vs. 50.4%, χ(2)=0.85, p=0.36) and of self-harm events (OR=0.5, 95% CI: 0.1-2.6, p=0.53) as those who received no sleep medication. These findings should be interpreted cautiously because these sleep agents were not assigned randomly, but at clinician discretion. Nevertheless, they suggest that the use of trazodone for the management of sleep difficulties in adolescent depression should be re-evaluated and that future research on the management of sleep disturbance in adolescent depression is needed. The very low response rate of participants cotreated with trazodone and either fluoxetine or paroxetine could be due to inhibition of CYP 2D6 by these antidepressants.

Desenvolvimento da versão breve da Escala de Ritmo Social

OBJETIVO: O objetivo deste trabalho é o estabelecimento de uma versão abreviada da Escala de Ritmo Social, com vistas à aplicação em pesquisa. MÉTODOS: Tomando como padrão-ouro a Escala de Ritmo Social de 17 itens, estabelecidas três versões breves a partir de três critérios diferentes. Comparados escores de regularidade e quantidade de atividades desenvolvidas em um período de uma semana de 167 sujeitos saudáveis, 25 portadores de epilepsia mioclônica juvenil e 16 portadores de transtorno depressivo. RESULTADOS: A versão breve de seis itens mostrou melhor concordância com relação ao padrão-ouro k = 0,51; p &lt; 0,001. A análise bivariada demonstrou significativa correlação entre a versão breve-6 e o padrão-ouro: (r = 0,87; p &lt; 0,001). Houve correlação com idade na versão breve-6 (r = 0,2; p &lt; 0,001), ainda mais significativa do que no padrão-ouro (r = 0,2; P &lt; 0,01). Na análise ANOVA, o grupo saudável apresentou escores mais altos de regularidade em ambas as escalas. Com relação à quantidade de atividades, o grupo saudável assemelhou-se ao dos portadores de epilepsia e o dos portadores de depressão apresentou médias mais baixas. CONCLUSÃO: A simplificação da escala diminui a porcentagem de itens não preenchidos e custo em material impresso e facilita a padronização. O processo envolveu cuidadosa análise da adequação do instrumento à cultura-alvo.

P-742 - Cognitive disturbances in the primary health care patients suffering with organic and anxiety-depressive disorders

Differential evaluation of cognitive, anxiety and depressive disturbances presents an important issue in clinical qualification of the patients attending primary health care. The paper studies the feasibility of the psychometric tests application for this purpose. A total of 60 patients (10 men, 50 female) aged from 18 to 75, that were on treatment in a district policlinic, were studied. The first group included 23 patients with anxiety-depressive spectrum disorders (ADSD), the second group - 17 patients with mild organic mental disorders (MOMD), the third group - 20 patients with combination of these disorders (ADSD+MOMD). The fourth group consisted of 26 healthy persons. The following psychometric instruments were used: Screening Questionnaire for Identifying Risk of Affective Disorder Spectrum, Hospital Anxiety and Depression Scale, Beck Depression Inventory, the methods “10 Words List Recall”, “Six Figures Recall”, and “Objects Exclusion”. Results of the study showed, that these tests help to improve diagnosing and differentiation of cognitive impairments in ADSD, MOMD, and ADSD+MOMD. In particular, the patients with MOMD are characterized by disorders of verbal and visual image memory, decrease of internal determination of estimates, and narrowing of the range of the meaning articulation. The patients with ADSD have no symptoms of the cognitive deficit changes, but they do have the cognitive style disturbances with some decrease of the working memory capacity, the trend to the decrease of the internal selection consistency and rather good ability to articulate the meanings. In the cases of ADSD+MOMD there is a combination of the above specified traits.

A preliminary investigation of symptom pattern and prevalence before and up to 6 months after implantation of a left ventricular assist device

Despite increased use of left ventricular assist devices (LVAD) in patients with advanced or end-stage heart failure; little is known about the reoccurrence of common heart failure symptoms (e.g., fatigue) after LVAD implantation. The objective of this study was to investigate the prevalence and pattern of selected heart failure symptoms and identify changes in symptom patterns before and up to 6 months after LVAD implantation. We used self-report questionnaires to collect data from patients (n = 12) and measure symptoms at baseline, 1 and 2 weeks, and 1, 3, and 6 months after LVAD. We found that high levels of fatigue, anxiety, depression, and sleep disturbance were prevalent during these periods. However, we did not find any significant changes in symptom pattern over time. The preliminary findings set the starting point for large-scale studies fundamental to advances in symptom-management research in LVAD and for other patients living with artificial organs.

Interaction of the Bc II glucocorticoid receptor polymorphism and childhood abuse in bulimia nervosa (BN): Relationship to BN and to associated trait manifestations

We recently documented a gene-environment interaction suggesting that individuals with Bulimia Nervosa (BN) differed from normal eaters as to the combined presence of the low-function allele of the glucocorticoid receptor polymorphism, Bc II, and childhood abuse. The present study examined the extent to which any such interaction effect may have been attributable to behavioral impulsivity, sensation seeking, affective instability or depression. We had 174 bulimic and 130 nonbulimic women provide blood for genetic assays, and measured psychopathological traits and childhood abuse using structured interviews and self-report questionnaires. As expected, we observed a significant Bc II × abuse interaction indicating genetic and environmental susceptibilities to co-occur significantly more often in bulimic than in nonbulimic individuals. The Bc II × abuse interaction was attenuated when levels of depression were accounted for, but was surprisingly unaffected by controls for motoric impulsivity, sensation seeking or affective instability. Our findings suggest that stress-induced alterations in glucocorticoid sensitivity contribute to BN and depressive disturbances—without being associated with the behavioral/affective dysregulation seen in many BN sufferers. We discuss theoretical and clinical implications of these observations.

Effect of animal-assisted therapy on the psychological and functional status of elderly populations and patients with psychiatric disorders: a meta-analysis

Animal-assisted therapy (AAT) may affect health via an increase in perceived social support and social interaction. A meta-analysis was conducted to determine its effects on selected populations with poor social functioning. Studies involving elderly participants and those with depression and schizophrenia were searched in Medline, PsycINFO and Cochrane up to January 2009. Matched or controlled trials incorporating pre- and post-test outcome measures and with at least five participants subjected to a multiple-day AAT intervention were selected (n=21). Participants' characteristics, study design, intervention features, outcome variables, reported effects and study quality were retrieved. Design-specific effect sizes were pooled using random-effects models. Heterogeneity of effects by study characteristics, including target population and intervention features, was explored through meta-regression. Pooled effect sizes were calculated for social functioning, depression, anxiety, behavioural disturbances, loneliness, daily living skills and cognitive status. As hypothesised, AAT improved social functioning (pooled effect size = 1.06, n=275). Moderate effects were found for depression (−0.34, n=447), anxiety (−0.29, n=291) and behavioural disturbances (−0.32, n=367). Effects on social functioning and depression were larger in individuals with psychiatric conditions while behavioural disturbances were reduced in patients with dementia. The inconsistent methodological characteristics of the studies meta-analysed suggest a conservative interpretation of these findings.

Managing impulse control disorders

Growing evidence links some treatments for Parkinson’s disease (PD) and restless leg syndrome (RLS) to a range of ‘impulse control disorders’ (ICDs), including pathological gambling, hypersexuality, compulsive shopping and binge eating. ICDs are relatively common. In one study, 13.6% of patients with PD showed ICDs. In another study, 17% of patients with RLS taking dopaminergic agents developed ICDs. Prescribing dopaminergic therapy at the lowest effective dose helps reduce the risk. Nurses should remind and educate patients— and, when possible, their families—about the risk of ICD. While the likelihood of developing ICDs is highest during the first few months of treatment with dopamine agonists, nurses should remain alert for the complication during each clinical encounter. ICDs may be managed through, for example: reducing the dose of or withdrawing the dopamine agonist; cognitive behavioural therapy; and support from self-help groups. Dysphoria appears to contribute to, and helps maintain ICDs, and nurses should manage depression, mood changes and sleep disturbances. Nurses need to remain vigilant for this complex, enigmatic, but fascinating condition.

Familial Aggregation of Panic Disturbances in Parkinson's Disease

Familial Aggregation of Panic Disturbances in Parkinson's Disease

Depression, anxiety and prolonged sleep latency in glaucoma: Evidence for circadian alteration?

Glaucoma is a chronic, progressive optic neuropathy [1]. Excessive retinal oxidative stress is considered a major pathophysiological pathway leading to glaucomatous alterations, visual field defects (VFD) and neurodegeneration with progressive loss of the retinal ganglion cells (RGC) and herewith to an affected light transmission to the suprachiasmatic nucleus (SCN) [2, 3]. Progressed glaucoma has been therefore lately suggested to be the main ophthalmologic disease affecting the photic input to the circadian system, leading to an impairment of the photo-dependent melatonin production and to an affection of the circadian rhythm and thus to several physiological consequences, including sleep and affective disorders [4]. However, with respect to depression and sleep disturbance, study results are sparse and contradictory [5, 6]. The objective of this study is the investigation of the prevalence and specific psychopathology of sleep disorders, depressive and anxiety symptoms among glaucoma patients with and without VFD. Herewith, the correlation between visual impairment, circadian disarrangement and depression should be further explored.