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Abstracts

• Predictors of light therapy

AUTHOR(S): Krauchi K; Wirz-Justice A; Graw P

AUTHOR'S ADDRESS: Psychiatric University Clinic, Basel, Switzerland.

ARTICLE TITLE: High intake of sweets late in the day predicts a rapid and persistent response to light therapy in winter depression.

ARTICLE SOURCE: Psychiatry Res (Ireland), Feb 1993, 46(2) p107-17

ABSTRACT: Demographic characteristics, depression ratings, and detailed daily records of symptoms were examined as possible predictors of the response to light therapy of 51 patients with seasonal affective disorder. Of 26 items, high intake ( 1 portion) of sweets in the second half of the day was the best predictor of a rapid and persistent response to light therapy. The intake of sweets may either act on similar neurochemical substrates to those affected by light or provide a behavioral marker for individuals susceptible to light response.

AUTHOR(S): Lam RW

AUTHOR'S ADDRESS: Division of Mood Disorders, University of British Columbia, Vancouver, Canada.

ARTICLE TITLE: Morning light therapy for winter depression: predictors of response.

ARTICLE SOURCE: Acta Psychiatr Scand (Denmark), Feb 1994, 89(2) p97-101

ABSTRACT: Bright-light therapy is widely regarded as an effective treatment for winter seasonal affective disorder (SAD). We attempted to identify predictors of light therapy response in 54 depressed, drug-free outpatients diagnosed with SAD by DSM-III-R criteria. After a baseline week, patients were treated for 2 weeks with 2500-lx cool-white fluorescent light exposure from 0600 to 0800 daily. The results showed that light therapy significantly reduced depression scores. Several indices of atypical and typical symptoms correlated with response, but none was clearly superior to the pre-treatment depression score. A multiple regression analysis identified 3 factors (hypersomnia, increased eating and younger age) that predicted light-therapy response. These results suggest that specific symptoms of hypersomnia and hyperphagia are predictors of response to morning bright-light therapy in SAD.

AUTHOR(S): Oren DA; Jacobsen FM; Wehr TA; Cameron CL; Rosenthal NE

AUTHOR'S ADDRESS: Clinical Psychobiology Branch, National Institute of Mental Health, Bethesda, MD 20892.

ARTICLE TITLE: Predictors of response to phototherapy in seasonal affective disorder [published erratum appears in Compr Psychiatry 1992 Nov-Dec; 33(6):419]

ARTICLE SOURCE: Compr Psychiatry (United States), Mar-Apr 1992, 33(2) p111-4

ABSTRACT: We examined data from 44 women with seasonal affective disorder (SAD) to determine whether any demographic, diagnostic, or symptomatic characteristics would be predictive of a favorable response to phototherapy. Preexistent hypersomnia was particularly associated with lessening of depression after phototherapy. In contrast to a report elsewhere, both "typical" and "atypical" depressive symptoms correlated with improvement after phototherapy.

AUTHOR(S): Terman M; Amira L; Terman JS; Ross DC

AUTHOR'S ADDRESS: Department of Psychiatry, Columbia University, New York, USA.

ARTICLE TITLE: Predictors of response and nonresponse to light treatment for winter depression.

ARTICLE SOURCE: Am J Psychiatry (United States), Nov 1996, 153(11) p1423-9

ABSTRACT: OBJECTIVE: The authors' goal was to determine whether the pattern and severity of depressive symptoms predict response to light treatment for seasonal affective disorder. METHOD: Subjects with winter depression (N = 103) were given bright light treatment. Seventy-one were classified as responders, 15 as nonresponders, and 17 as partial responders. Using depression rating scale data and correlational and multivariate analysis, the authors sought predictors of response in baseline symptom and scale scores. RESULTS: Responders were characterized by atypical symptoms, especially hypersomnia, afternoon or evening slump, reverse diurnal variation (evenings worse), and carbohydrate craving. By contrast, nonresponders were characterized mainly by melancholic symptoms, retardation, suicidality, depersonalization, typical diurnal variation (mornings worse), anxiety, early and late insomnia, appetite loss, and guilt. The ratio of atypical to classical symptoms of depression, rather than severity per se, best predicted treatment outcome for the group as a whole. Pretreatment expectations were positively correlated with improvement on the Hamilton Depression Rating Scale but not on a supplementary scale of atypical symptoms. CONCLUSIONS: Light-responsive seasonal affective disorder is distinguished by a dominant atypical symptom profile closely associated with depressed mood. Nonresponders from a clinically distinct group with melancholic features. The patient's symptom profile, therefore, should be considered when diagnosing seasonal affective disorder and selecting treatment.

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