Abstract

Patients with the major depressive disorder usually manifest with sleep disturbance. Early morning awakening is more closely related to major depressive disorder than other sleep disturbances. This study aimed to assess the effect of early morning awakening in treating patients with major depressive disorder. The eligible patients were divided into two groups according to whether they woke up at 2-4 a.m: early morning awakening and non-early morning awakening group. All patients were assessed using the Hamilton Depression Scale, Hamilton Anxiety Scale, and Repeatable Battery for the Assessment of Neuropsychological Status scores at baseline and the fourth week. Twenty-one men and 31 women (mean age 25.13 ±10.67 years) were enrolled. There was a significant main effect of early morning awakening in the Hamilton Depression Scale (P = 0.04) and Hamilton Anxiety Scale (P = 0.01) at the fourth week after treatment. But there was no significant difference in cognitive changes between the two groups. In conclusion, a major depressive disorder with early morning awakening may result in statistically and
clinically significant delay in recovery.