Experts' opinions

Abstracts

• Non-seasonal affective disorder

AUTHOR(S): Kripke DF; Mullaney DJ; Klauber MR; Risch SC; Gillin JC

AUTHOR'S ADDRESS: Department of Psychiatry, University of California, San Diego.

ARTICLE TITLE: Controlled trial of bright light for nonseasonal major depressive disorders.

ARTICLE SOURCE: Biol Psychiatry (United States), Jan 15 1992, 31(2) p119-34

ABSTRACT: Psychotropic drug-free hospitalized veterans with nonseasonal major depressive disorders or depressed forms of bipolar disorder were treated with light for 1 week. Twenty-five patients were randomly assigned to bright white light treatment (2000-3000 lux), and 26 patients were randomized to dim red light placebo control treatment. Unlike those treated with dim red light, those treated with bright white light showed declines in three measures of depression during treatment. Partial relapse appeared within 2 days. A global depression score showed a statistically significant (p = 0.02) difference favoring bright white light treatment. Two bright-light-treated patients became mildly hypomanic, but side effects were mild. Improvement was not correlated with patient expectations; indeed, patients expected somewhat greater benefit from the placebo. Patients treated in summer responded as well as those treated in winter. Baseline electroencephalogram (EEG) sleep stage data (e.g., rapid eye movement; REM latency) did not predict treatment responses. These 1-week treatment results suggest that bright light might produce benefits for patients with nonseasonal depression. Bright light should not be recommended for routine clinical application before additional assessments with longer treatment durations are done.

AUTHOR(S): Yamada N; Martin-Iverson MT; Daimon K; Tsujimoto T; Takahashi S

AUTHOR'S ADDRESS: Department of Psychiatry, Shiga University of Medical Science.

ARTICLE TITLE: Clinical and chronobiological effects of light therapy on nonseasonal affective disorders.

ARTICLE SOURCE: Biol Psychiatry (United States), Jun 15 1995, 37(12) p866-73

ABSTRACT: Light therapy (bright or dim light) was given at different times (morning or evening) to 27 unmedicated patients with nonseasonal depression (according to DSM-III-R criteria) and 16 normal volunteers. Circadian rhythms in body temperature were measured before and after light therapy. Bright light significantly improved clinical symptoms of depression, as measured by the Hamilton Rating Scale for Depression (HRSD), independent of the time of phototherapy. Dim light therapy had no effect on HRSD scores. Circadian rhythms of body temperatures in patients with affective disorder were more sensitive to the entraining effects of bright light than those of normal subjects, but these effects were not related to clinical improvement. Bright light exposure has an antidepressant effect on patients with nonseasonal depression, but the effect is unlikely to be mediated via the same circadian system that regulates body temperature.

AUTHOR(S): Thalen BE; Kjellman BF; Morkrid L; Wibom R; Wetterberg L

AUTHOR'S ADDRESS: Karolinska Institute, Department of Psychiatry, St. Goran's Hospital, Stockholm, Sweden.

ARTICLE TITLE: Light treatment in seasonal and nonseasonal depression.

ARTICLE SOURCE: Acta Psychiatr Scand (Denmark), May 1995, 91(5) p352-60

ABSTRACT: Ninety patients with major depressive disorder were classified according to seasonal (n = 68, 50 women) or nonseasonal (n = 22, 17 women) pattern according to DSM-III-R. They were also clinically evaluated and rated before and after morning (0600-0800) or evening (1800-2000) light treatment for 10 days in a room with a luminance of 350 cd/m2 (approximately 1500 lx) at eye level. Mood ratings were performed using both the Comprehensive Psychopathological Rating Scale and the Hamilton Depression Rating Scale. Depressed patients with seasonal pattern improved significantly more than those with a nonseasonal pattern suggesting a specific nonplacebo effect of light treatment in depressed patients with seasonal pattern. There were no significant differences in outcome when light treatment was given in the morning or in the evening, and not between patients with and without atypical symptoms such as carbohydrate craving or increased appetite.

AUTHOR(S): Thalen BE; Kjellman BF; Morkrid L; Wetterberg L

AUTHOR'S ADDRESS: Karolinska Institute, Department of Clinical Neuroscience, Stockholm, Sweden.

ARTICLE TITLE: Melatonin in light treatment of patients with seasonal and nonseasonal depression.

ARTICLE SOURCE: Acta Psychiatr Scand (Denmark), Oct 1995, 92(4) p274-84

ABSTRACT: Melatonin as a marker of circadian rhythm and the effect of bright light on melatonin were studied in 63 depressed patients, 42 with a seasonal pattern and 21 with a nonseasonal pattern. The patients were matched for age, time of treatment and severity of depression. Before light treatment, blood was sampled for melatonin and depression was clinically rated with the Comprehensive Psychopathological Rating Scale and Hamilton Depression Rating Scale. Two hours of light treatment, 350 cd/m2, was given daily for 10 days 0600 to 0800 or 1800 to 2000. Of the 42 patients with seasonal depression, 26 were treated with morning light and, 16 with evening light. The melatonin amplitude was significantly decreased by light, and the melatonin phase position was advanced by morning light and delayed by evening light. All patients except for 3 in each group changed in the expected direction. Although the patients with seasonal pattern had a more favorable outcome than patients with nonseasonal pattern, there was no difference in therapeutic outcome related to the baseline melatonin phase position. The hypothesis that the short term clinical effects of light therapy either in the morning or evening are related to pretreatment melatonin levels or alteration of melatonin amplitude or phase position was not supported in the study. There was also no significant difference between the seasonal and nonseasonal patients related to the degree of light suppression of melatonin and the rebound effect of serum melatonin levels following bright level exposure between 2200 and 2300 before regular light treatment.

Print • Imprint • General terms and conditions •Contact