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Chen X, Liu L, Mei H, Jiang Z, Yan W, Shi L, Liu X, Yuan K, Zhang Y, Luo X, Zhang L, Zhao Y, Wu S, Chen B, Yuan J, Liu Z, Cai H, Meng S, Shi J, Li X, Hu B, Deng J, Lu L, Bao Y. Efficacy evaluation and facial expressions biomarker of light therapy in youths with subthreshold depression: A randomized control trial study. J Affect Disord 2025; 380:357-365. [PMID: 40122251 DOI: 10.1016/j.jad.2025.03.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2024] [Revised: 03/19/2025] [Accepted: 03/20/2025] [Indexed: 03/25/2025]
Abstract
BACKGROUND Simpler and more feasible light therapy protocols, and objective indicators for assessing its effectiveness is lacking. We aimed to evaluate the efficacy of light therapy on subthreshold depression (SD) among college students and explore facial expressions as an objective biomarker across different treatment groups. METHODS From September 13, 2021, to January 4, 2022, college students with SD were recruited from a university in Hubei Province, randomly assigned to Bright Light Therapy (BLT) group (10,000 lx), Dim Light Therapy (DLT) group (200 lx), or Waiting List Control (WLC) group (no intervention). Self-reported questionnaire and facial expressions were assessed for all participants before and after intervention. Repeated measures ANOVA and logistic regression were conducted to compare baseline and post-intervention differences among three groups. RESULTS 135 participants were enrolled and 121 participants completed the study. Depression symptom and sleep quality scores significantly decreased in both BLT and DLT groups (P < 0.001), while no significant changes were observed in WLC group. BLT (OR, 4.50; 95 % CI, 1.11-18.27; P = 0.035) and DLT group (OR, 4.17; 95 % CI, 1.04-16.79; P = 0.045) had higher efficacy rates than WLC group. For facial expressions, DLT group showed significant increases in two happy-related facial action units (AU) including AU14 values (positive, negative and neutral stimuli) and AU26 values (neutral and negative stimuli). BLT group showed a significant decrease in fear-related AU20 values under negative stimuli (P < 0.001). CONCLUSION Light therapy improves depressive symptoms and sleep quality in individuals with SD, and facial expressions can serve as an objective biomarker to support its effectiveness.
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Affiliation(s)
- Xin Chen
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Huan Mei
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Zhendong Jiang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan 430063, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Xiaoxing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
| | - Yanhua Zhang
- Huazhong Agricultural University, Wuhan 430070, China
| | - Xiaoyu Luo
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan 430063, China
| | - Liguo Zhang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan 430063, China
| | - Yimiao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Shuilin Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Bailin Chen
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Jiaqian Yuan
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Zhenyu Liu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Hanshu Cai
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China
| | - Shiqiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Xiangyou Li
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan 430063, China
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou 730000, China.
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China; Shandong Institute of Brain Science and Brain-inspired Research, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province 250117, China.
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China.
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Du L, Zeng J, Yu H, Chen B, Deng W, Li T. Efficacy of bright light therapy improves outcomes of perinatal depression: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res 2025; 344:116303. [PMID: 39657294 DOI: 10.1016/j.psychres.2024.116303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 11/24/2024] [Accepted: 11/29/2024] [Indexed: 12/12/2024]
Abstract
The efficacy of bright light therapy (BLT) in the context of perinatal depression remains underexplored. This meta-analysis aimed to systematically assess the effectiveness of BLT among perinatal depression. A comprehensive literature search was performed across several databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, CNKI and the clinical trials registry platform, covering the period from the inception of each database up to January 2024. The Cochrane Collaboration's bias assessment tool was employed to evaluate the quality of the included studies. Review Manager 5.3 Software was utilized to conduct the meta-analysis. Six trials, encompassed a total of 167 participants diagnosed with perinatal depression were incorporated quantitative analysis, all of those have been published in English, with no restriction on publication year, and used BLT and dim light therapy (DLT) as intervention. The relative risk (RR) of BLT compared to DLT for perinatal depression is 1.46 (fixed effects model, p = 0.04, 95 % CI = [1.02, 2.10]), indicating a significant improvement in depression outcomes compared to DLT groups. The heterogeneity test yielded an I2 value of 41 % (p = 0.13), indicated a low degree of heterogeneity. Considering the small sample size, we conducted a sensitivity analysis, found RR increased to 2.33 (fixed effects model, p = 0.001, CI = 1.39-3.92). Cochrane Risk of Bias Tool showed only a single study was deemed high quality. This study indicates a beneficial impact of BLT on perinatal depression, subgroup analysis finds no significant mediation effects of different parameters after sensitivity analyses. It is recommended that future studies with larger samples be conducted to explore the effects of BLT on perinatal depression.
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Affiliation(s)
- Lian Du
- Department of psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China; Key Laboratory of Major Brain Disease and Aging Research (Ministry of Education) , Chongqing Medical University, Chongqing, China
| | - Jinkun Zeng
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China
| | - Hua Yu
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China
| | - Bijun Chen
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China
| | - Wei Deng
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China
| | - Tao Li
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310013, China; Nanhu Brain-computer Interface Institute, Hangzhou 311100, China; Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou 311121, China.
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Stefani O, Schöllhorn I, Münch M. Towards an evidence-based integrative lighting score: a proposed multi-level approach. Ann Med 2024; 56:2381220. [PMID: 39049780 PMCID: PMC11275531 DOI: 10.1080/07853890.2024.2381220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 07/27/2024] Open
Abstract
Background: Human circadian clocks are synchronized daily with the external light-dark cycle and entrained to the 24-hour day. There is increasing evidence that a lack of synchronization and circadian entrainment can lead to adverse health effects. Beyond vision, light plays a critical role in modulating many so-called non-visual functions, including sleep-wake cycles, alertness, mood and endocrine functions. To assess (and potentially optimize) the impact of light on non-visual functions, it is necessary to know the exact 'dose' (i.e. spectral irradiance and exposure duration at eye level) of 24-hour light exposures, but also to include metadata about the lighting environment, individual needs and resources. Problem statement: To address this problem, a new assessment tool is needed that uses existing metrics to provide metadata and information about light quality and quantity from all sources. In this commentary, we discuss the need to develop an evidence-based integrative lighting score that is tailored to specific audiences and lighting environments. We will summarize the most compelling evidence from the literature and outline a future plan for developing such a lighting score using internationally accepted metrics, stakeholder and user feedback. Conclusion: We propose a weighting system that combines light qualities with physiological and behavioral effects, and the use of mathematical modelling for an output score. Such a scoring system will facilitate a holistic assessment of a lighting environment, integrating all available light sources.
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Affiliation(s)
- Oliver Stefani
- Lucerne School of Engineering and Architecture, Lucerne University of Applied Sciences and Arts, Horw, Switzerland
| | - Isabel Schöllhorn
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Mirjam Münch
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
- Research Cluster Molecular Cognitive Neuroscience, University of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
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Qiao MX, Yu H, Li T. Non-invasive neurostimulation to improve sleep quality and depressive symptoms in patients with major depressive disorder: A meta-analysis of randomized controlled trials. J Psychiatr Res 2024; 176:282-292. [PMID: 38905761 DOI: 10.1016/j.jpsychires.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 05/29/2024] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Non-invasive neurostimulation, including bright light therapy (BLT), repetitive transcranial magnetic (rTMS) and transcranial direct current stimulation (tDCS), has been shown to alleviate depressive symptoms in major depressive disorder (MDD). However, the efficacy of these interventions in addressing sleep disturbances in MDD patients remains a subject of debate. OBJECTIVE We aimed to conduct a meta-analysis of available randomized controlled trials (RCTs) to assess the effectiveness of non-invasive neurostimulation in improving sleep disturbances and depressive symptoms in MDD patients. METHODS Systematic searches for relevant RCTs were conducted in the databases PubMed, Cochrane Library, Web of Science, EMBASE, Wanfang and China National Knowledge Infrastructure up to January 2024. Data on outcomes comparable across the studies were meta-analyzed using Review Manager 5.3 and Stata 14. The pooled results were reported as standardized mean differences (SMD) with their respective 95% confidence intervals (CI). RESULTS Our analysis encompassed 15 RCTs involving 1348 patients. Compared to sham or no stimulation, non-invasive neurostimulation significantly improved sleep quality (SMD -0.74, 95%CI -1.15 to -0.33, p = 0.0004) and sleep efficiency (SMD 0.35, 95%CI 0.10 to 0.60, p = 0.006). It also significantly reduced severity of depressive symptoms (SMD -0.62, 95%CI -0.90 to -0.35, p < 0.00001). Subgroup analysis further demonstrated that patients experiencing sleep improvements due to neurostimulation showed a marked decrease in depressive symptoms compared to the control group (SMD = -0.90, 95% CI [-1.26, -0.54], p < 0.0001). CONCLUSION Current evidence from RCTs suggests that neurostimulation can enhance sleep quality and efficiency in individuals with MDD, which in turn may be associated with mitigation of depressive symptoms. PROSPERO REGISTRATION CRD42023423844.
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Affiliation(s)
- Meng-Xuan Qiao
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China; Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Hua Yu
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China; Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China; NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China.
| | - Tao Li
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China; Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China; Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China; NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China.
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Chen G, Guo Z, Chen P, Yang Z, Yan H, Sun S, Ma W, Zhang Y, Qi Z, Fang W, Jiang L, Tao Q, Wang Y. Bright light therapy-induced improvements of mood, cognitive functions and cerebellar functional connectivity in subthreshold depression: A randomized controlled trial. Int J Clin Health Psychol 2024; 24:100483. [PMID: 39101053 PMCID: PMC11296024 DOI: 10.1016/j.ijchp.2024.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/25/2024] [Indexed: 08/06/2024] Open
Abstract
Background The efficacy of bright light therapy (BLT) in ameliorating depression has been validated. The present study is to investigate the changes of depressive symptoms, cognitive function and cerebellar functional connectivity (FC) following BLT in individuals with subthreshold depression (StD). Method Participants were randomly assigned to BLT group (N = 47) or placebo (N = 41) in this randomized controlled trial between March 2020 and June 2022. Depression severity and cognitive function were assessed, as well as resting-state functional MRI scan was conducted before and after 8-weeks treatment. Seed-based whole-brain static FC (sFC) and dynamic FC (dFC) analyses of the bilateral cerebellar subfields were conducted. Besides, a multivariate regression model examined whether baseline brain FC was associated with changes of depression severity and cognitive function during BLT treatment. Results After 8-week BLT treatment, individuals with StD showed improved depressive symptoms and attention/vigilance cognitive function. BLT also increased sFC between the right cerebellar lobule IX and left temporal pole, and decreased sFC within the cerebellum, and dFC between the right cerebellar lobule IX and left medial prefrontal cortex. Moreover, the fusion of sFC and dFC at baseline could predict the improvement of attention/vigilance in response to BLT. Conclusions The current study identified that BLT improved depressive symptoms and attention/vigilance, as well as changed cerebellum-DMN connectivity, especially in the cerebellar-frontotemporal and cerebellar internal FC. In addition, the fusion features of sFC and dFC at pre-treatment could serve as an imaging biomarker for the improvement of attention/vigilance cognitive function after BLT in StD.
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Affiliation(s)
- Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Zixuan Guo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Zibin Yang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Hong Yan
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Shilin Sun
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Wenhao Ma
- Department of Public Health and Preventive Medicine, School of Basic Medicine, Jinan University, Guangzhou 510632, China
- Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou 510632, China
| | - Yuan Zhang
- Department of Public Health and Preventive Medicine, School of Basic Medicine, Jinan University, Guangzhou 510632, China
- Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou 510632, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
| | - Wenjie Fang
- Department of Public Health and Preventive Medicine, School of Basic Medicine, Jinan University, Guangzhou 510632, China
- Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou 510632, China
| | - Lijun Jiang
- Department of Public Health and Preventive Medicine, School of Basic Medicine, Jinan University, Guangzhou 510632, China
- Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou 510632, China
| | - Qian Tao
- Department of Public Health and Preventive Medicine, School of Basic Medicine, Jinan University, Guangzhou 510632, China
- Division of Medical Psychology and Behavior Science, School of Basic Medicine, Jinan University, Guangzhou 510632, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, 510630, China
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Reis DJ, Schneider AL, King SE, Forster JE, Bahraini NH. Delivery of bright light therapy within the Veterans Health Administration. J Affect Disord 2024; 349:1-7. [PMID: 38154586 DOI: 10.1016/j.jad.2023.12.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/28/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Bright light therapy (BLT) is efficacious for seasonal and non-seasonal depression. However, the current state of BLT use in practice is unknown, impeding efforts to identify and address utilization gaps. This study's objective was to investigate BLT delivery in a nationwide U.S. healthcare system. METHODS This was a retrospective observational study of electronic medical records from all veterans who received outpatient mood disorder-related care in the Veterans Health Administration (VHA) from October 2008 through September 2020. BLT delivery was measured through the placement of light box consults. RESULTS Of the 3,442,826 veterans who received outpatient mood disorder care, only 57,908 (1.68 %) received a light box consult. Consults increased by 548.44 % (99.9 % credible interval: 467.36 %, 638.74 %) over the timeframe and displayed a robust yearly cycle that peaked on either December 21st or December 22nd. Past mental health treatment for a mood disorder was associated with a higher probability of a consult (relative risk = 4.79, 99.9 % CI: 4.21, 5.60). There was low representation related to veteran age, gender, race, and ethnicity. LIMITATIONS No information on patients who declined light boxes or actual light box use following consult placement. CONCLUSIONS Outpatient BLT delivery for mood disorders in the VHA remains low, despite significant growth over the past decade. It also displays a strong seasonal rhythm that peaks on the winter solstice, suggesting a limited focus on seasonal depression and a suboptimal reactive approach to changing sunlight. Overall, there exists ample opportunity for novel implementation efforts aimed at increasing utilization of BLT.
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Affiliation(s)
- Daniel J Reis
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Alexandra L Schneider
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA
| | - Samuel E King
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA
| | - Jeri E Forster
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nazanin H Bahraini
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Affiliation(s)
- Art Walaszek
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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Meesters Y, van Tuinen EJD, Gordijn MCM. 35 years of light treatment for mental disorders in the Netherlands. Ann Med 2023; 55:2269574. [PMID: 37857364 PMCID: PMC10588530 DOI: 10.1080/07853890.2023.2269574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Light therapy (LT) for Seasonal Affective Disorders (SAD) has been a well-known and effective treatment for 40 years. The psychiatric university clinic of Groningen, the Netherlands was an early adopter and started research and treatment of SAD in 1987. Research projects on mechanisms, the role of the circadian system, treatment optimization, and investigating new areas for the effects of light treatment have been carried out ever since, leading to a widespread interest across the country. OBJECTIVE To provide an overview and description of the historical development of LT for mental disorders in the Netherlands. METHODS A non-systematic, review of research on light treatment for mental problems in the Netherlands, published since 1987 was conducted. RESULTS The fields of LT and chronotherapy are strongly based in the scientific interests of both chrono-biologists and therapists in the Netherlands. LT has shown effectiveness in treating mood disorders. Likewise, results for other mental disorders have shown some promise, but so far, the outcomes are not always unequivocal and have not always been based on robust data. Ongoing research is discussed. CONCLUSIONS LT, and in addition exposure to the right light at the right time is an important issue in mental health. Over the past 3 decades research on light and LT in the Netherlands has become well established and is still growing.
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Affiliation(s)
- Y. Meesters
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - E. J. D. van Tuinen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M. C. M. Gordijn
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
- Chrono@Work, Groningen, the Netherlands
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Ballard R, Parkhurst J, Julian K, Pasetes LN, Fawcett A, Li A, Goel N, Sit DK. Light Therapy for Adolescent Depression: A Scoping Review. Curr Psychiatry Rep 2023; 25:373-386. [PMID: 37490215 DOI: 10.1007/s11920-023-01437-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Depressive disorders in adolescents are a major health concern associated with developmental, social, and educational impairment. Bright Light Therapy (BLT) is a feasible and effective treatment for depressive disorders in adults, but few controlled trials have been conducted with children or adolescents. This scoping review focuses on the current state of knowledge for BLT in the treatment of adolescent depression. We reviewed the literature for novel data and methodologic approaches using BLT and pediatric and young adult populations. RECENT FINDINGS BLT is a tolerable treatment with few side effects. However, there is a marked lack of well-powered studies to support BLT as a treatment for depressive disorders in adolescent populations. Given evidence of tolerability and positive treatment effect on depression in the adult literature, research is needed to establish the efficacy, feasibility, and acceptability of BLT in adolescents.
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Affiliation(s)
- Rachel Ballard
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 10, 60611, Chicago, IL, USA
| | - John Parkhurst
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 10, 60611, Chicago, IL, USA
| | - Kelsey Julian
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 10, 60611, Chicago, IL, USA
| | - Lauren N Pasetes
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, 60612, Chicago, IL, USA
| | - Andrea Fawcett
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Box 10, 60611, Chicago, IL, USA
| | - Addie Li
- Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1000, 60611, Chicago, IL, USA
| | - Namni Goel
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 425, 60612, Chicago, IL, USA
| | - Dorothy K Sit
- Asher Center for the Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 1000, 60611, Chicago, IL, USA.
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Chakrabarti S, Jolly AJ, Singh P, Yadhav N. Role of adjunctive nonpharmacological strategies for treatment of rapid-cycling bipolar disorder. World J Psychiatry 2023; 13:495-510. [PMID: 37701540 PMCID: PMC10494771 DOI: 10.5498/wjp.v13.i8.495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/23/2023] [Accepted: 07/11/2023] [Indexed: 08/17/2023] Open
Abstract
Rapid-cycling bipolar disorder (RCBD) is a phase of bipolar disorder defined by the presence of ≥ 4 mood episodes in a year. It is a common phenomenon characterized by greater severity, a predominance of depression, higher levels of disability, and poorer overall outcomes. It is resistant to treatment by conventional pharmacotherapy. The existing literature underlines the scarcity of evi-dence and the gaps in knowledge about the optimal treatment strategies for RCBD. However, most reviews have considered only pharmacological treatment options for RCBD. Given the treatment-refractory nature of RCBD, nonpharmacological interventions could augment medications but have not been adequately examined. This review carried out an updated and comprehensive search for evidence regarding the role of nonpharmacological therapies as adjuncts to medications in RCBD. We identified 83 reviews and meta-analyses concerning the treatment of RCBD. Additionally, we found 42 reports on adjunctive nonpharmacological treatments in RCBD. Most of the evidence favoured concomitant electroconvulsive therapy as an acute and maintenance treatment. There was pre-liminary evidence to suggest that chronotherapeutic treatments can provide better outcomes when combined with medications. The research on adjunctive psychotherapy was particularly scarce but suggested that psychoeducation, cognitive behavioural therapy, family interventions, and supportive psychotherapy may be helpful. The overall quality of evidence was poor and suffered from several methodological shortcomings. There is a need for more methodologically sound research in this area, although clinicians can use the existing evidence to select and individualize nonpharmacological treatment options for better management of RCBD. Patient summaries are included to highlight some of the issues concerning the implementation of adjunctive nonpharmacological treatments.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Chandigarh UT, India
| | - Amal J Jolly
- Department of Psychiatry, Black Country Healthcare NHS Foundation Trust, Dudley DY2 8PS, West Midlands, United Kingdom
| | - Pranshu Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan, India
| | - Nidhi Yadhav
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Chandigarh UT, India
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11
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Yao L, Zhang Z, Lam LT. The effect of light therapy on sleep quality in cancer patients: a systematic review and meta-analysis of randomized controlled trials. Front Psychiatry 2023; 14:1211561. [PMID: 37492065 PMCID: PMC10363736 DOI: 10.3389/fpsyt.2023.1211561] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/22/2023] [Indexed: 07/27/2023] Open
Abstract
Background Sleep problem is one of the major issues of cancer patients and may have detrimental effects on the ongoing treatment and recovery of patients. However, the evidence for the effect of light therapy on sleep problems in this population remained scarce. This study aimed to examine the effect of light therapy on self-reported and physiological measures of sleep quality of cancer patients. It also aimed to quantify the magnitude of the effect using a meta-analytical approach. Methods Six databases were searched for randomized control trials (RCTs). The primary outcome was the sleep quality using the Pittsburgh sleep quality index (PSQI) measurement of self-reported scores, and the secondary outcomes included total sleep time and sleep efficiency measured by actigraphy. Meta-analyses were performed with the random effects model using the RevMan software. The standardized mean difference (SMD) of the PSQI scores and other measures with their 95% confidence intervals (CIs) were used for assessing the treatment effect (CRD42023370947). Results Nine RCTs were identified and included in the study. Light therapy significantly improved the self-reported sleep quality with a reduction of the pooled PSQI score (SMD = -0.72; 95% CI: -1.24 to -0.21; p = 0.006). Regarding total sleep time (p = 0.72) and sleep efficiency (p = 0.47), no significant effects of light therapy were found. Conclusion Light therapy could improve self-reported sleep quality in cancer patients. However, due to the heterogeneity and small sample size of the included trials, the results should be interpreted cautiously. Trials with better designs and larger sample sizes are suggested to be conducted for a more definitive conclusion.Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=370947.
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Affiliation(s)
- Liqing Yao
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
| | - Zhiyi Zhang
- Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Lawrence T. Lam
- Faculty of Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China
- Faculty of Health, The University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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12
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Kosanovic Rajacic B, Sagud M, Pivac N, Begic D. Illuminating the way: the role of bright light therapy in the treatment of depression. Expert Rev Neurother 2023; 23:1157-1171. [PMID: 37882458 DOI: 10.1080/14737175.2023.2273396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Despite the growing number of different therapeutic options, treatment of depression is still a challenge. A broader perspective reveals the benefits of bright light therapy (BLT). It stimulates intrinsically photosensitive retinal ganglion cells, which induces a complex cascade of events, including alterations in melatonergic, neurotrophic, GABAergic, glutamatergic, noradrenergic, serotonergic systems, and HPA axis, suggesting that BLT effects expand beyond the circadian pacemaker. AREAS COVERED In this review, the authors present and discuss recent data of BLT in major depressive disorder, non-seasonal depression, bipolar depression or depressive phase of bipolar disorder, and seasonal affective disorder, as well as in treatment-resistant depression (TRD). The authors further highlight BLT effects in various depressive disorders compared to placebo and report data from several studies suggesting a response to BLT in TRD. Also, the authors report data showing that BLT can be used both as a monotherapy or in combination with other pharmacological treatments. EXPERT OPINION BLT is an easy-to-use and low-budget therapy with good tolerability. Future studies should focus on clinical and biological predictors of response to BLT, on defining specific populations which may benefit from BLT and establishing treatment protocols regarding timing, frequency, and duration of BLT.
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Affiliation(s)
- Biljana Kosanovic Rajacic
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marina Sagud
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
- University of Applied Sciences Hrvatsko Zagorje Krapina, Croatian Zagorje Polytechnic Krapina, Krapina, Croatia
| | - Drazen Begic
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
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13
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Canazei M, Papousek I, Weiss EM. Light Intervention Effects on Circadian Activity Rhythm Parameters and Nighttime Sleep in Dementia Assessed by Wrist Actigraphy: A Systematic Review and Meta-Analysis. THE GERONTOLOGIST 2022; 62:e614-e628. [PMID: 34788794 DOI: 10.1093/geront/gnab168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Persons with dementia often show circadian rhythm disturbances and sleep problems. Timed light exposure seems to be a promising nonpharmacological treatment option. In this review, meta-analyses were run on light effects on circadian activity rhythm parameters in persons with dementia measured with wrist actimetry. Furthermore, we update a Cochrane review, published in 2014, on actigraphically measured light effects in nighttime sleep parameters in persons with dementia. RESEARCH DESIGN AND METHODS Four electronic databases were searched for randomized controlled trials. Effects in meta-analyses were summarized by using mean differences and 95% confidence intervals. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to assess the risk of bias and registered the review protocol (PROSPERO: CRD42020149001). RESULTS Thirteen trials met inclusion criteria, and either utilized light therapy devices, ambient room lighting systems, or dawn-dusk interventions. Eleven of these studies were subjected to meta-analyses. They did not reveal significant light effects on circadian activity parameters: amplitude (p = .62; n = 313), acrophase (p = .34; n = 313), intradaily variability (p = .51; n = 354), and interdaily stability (p = .38; n = 354). Furthermore, no light effects were found on sleep parameters: total sleep duration (p = .53; n = 594), sleep efficiency (p = .63; n = 333), wake after sleep onset (p = .95; n = 212), and sleep onset latency (p = .26; n = 156). Subgroup analyses, pooling data from 3 studies including persons with Alzheimer's dementia, also did not show light effects on circadian activity and sleep parameters. The overall risk of bias of included studies was high. DISCUSSION AND IMPLICATIONS There is insufficient evidence for actigraphically measured circadian light effects in persons with dementia. More high-quality research is needed to recommend the application of adjunctive light.
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Affiliation(s)
- Markus Canazei
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Ilona Papousek
- Institute of Psychology, University of Graz, Graz, Austria
| | - Elisabeth M Weiss
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
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14
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Lian Z, Zhu C, Yuan H, Wang J. Association between changes in depressive symptoms and hip fracture among middle-aged and older Chinese individuals: a prospective cohort study. BMC Geriatr 2022; 22:844. [PMID: 36348273 PMCID: PMC9644634 DOI: 10.1186/s12877-022-03484-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although studies have shown that depressive symptoms are associated with an increased risk of hip fracture (HF). Depressive symptoms are dynamic, and it is unclear whether HF risk persists if depressive symptoms remit. This study aims to examine the associations between changes in depressive symptoms and HF risk. Methods Data were from the China Health and Retirement Longitudinal Study from 2011 to 2018. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (cutoff ≥ 10). Changes in depressive symptoms were classified into four groups by two successive surveys (stable low/no, recent-onset, recently remitted, and stable high depressive symptoms). Multivariable logistic regressions were performed to assess whether changes in depressive symptoms were associated with HF incidents reported through 2018, adjusting for age, sex, educational level, marital status and other potential confounding factors. Results In total, 8574 participants were included, 265 (3.1%) of whom had reported HF incidents in the subsequent 5-year period. Participants with recent-onset (OR = 1.97, 95% CI = 1.40–2.77) or stable high (OR = 2.15, 95% CI = 1.53–3.02) symptoms had a higher risk of HF than those with stable low/no depressive symptoms, whereas those with improved depressive symptoms (OR = 1.27, 95% CI = 0.89–1.82) had no elevation in HF risk. Conclusion Stable high and recent-onset depressive symptoms were associated with increased HF risk, and no elevated HF risk was observed if symptoms remitted, suggesting that strategies to reduce depressive symptoms may be beneficial for HF prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03484-8.
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15
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A critical overview of systematic reviews and meta-analyses of light therapy for non-seasonal depression. Psychiatry Res 2022; 314:114686. [PMID: 35753223 DOI: 10.1016/j.psychres.2022.114686] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022]
Abstract
Light therapy has increasingly been used in relieving non-seasonal depression. We aimed to summarize the evidence and evaluate the methodological quality regarding the effectiveness and safety of light therapy for non-seasonal depression from systematic reviews/meta-analyses (SRs/MAs). In this study, five databases were searched from their inceptions to January 24, 2022. SRs/MAs on light therapy treatment for non-seasonal depression were included. Methodological quality assessment was performed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and evidence quality assessment was performed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). Six SRs/MAs on light therapy treatment for non-seasonal depression were included. The AMSTAR-2 showed that the methodological level of five included SRs/MAs were evaluated as critically low quality, and one included SRs/MAs were rated as low quality. According to the evaluation results of GRADE, the quality of evidence was mostly unsatisfactory. The results and descriptions in the included SRs/MAs suggest that light therapy is effective as a non-pharmacological intervention for the treatment of non-seasonal depression. However, the generally unsatisfied evidence quality and methodological quality of the SRs/Mas indicate that these results must be interpreted with caution.
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16
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Baba H, Kito S, Nukariya K, Takeshima M, Fujise N, Iga J, Oshibuchi H, Kawano M, Kimura M, Mizukami K, Mimura M. Guidelines for diagnosis and treatment of depression in older adults: A report from the Japanese Society of mood disorders. Psychiatry Clin Neurosci 2022; 76:222-234. [PMID: 35274788 DOI: 10.1111/pcn.13349] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
The Committee for Treatment Guidelines of Mood Disorders, Japanese Society of Mood Disorders, published a Japanese guideline for the treatment of late-life depression in 2020. Based on that guideline, the present guideline was developed and revised to incorporate the suggestions of global experts and the latest published evidence. In the diagnosis of late-life depression, it is important to carefully differentiate it from bipolar disorders, depressive states caused by physical and organic brain disease, drug effects, and dementia, and to determine the comorbidity between late-life depression and dementia. It is necessary to fully understand the clinical characteristics and psychosocial background of late-life depression, evaluate the patient's condition, and provide basic interventions based on these factors. Problem-solving therapy, reminiscence therapy/life review therapy, and behavioral activation therapy, and other forms of psychotherapy can reduce depressive symptoms. In terms of pharmacotherapy, newer antidepressants or non-tricyclic antidepressants are recommended for late-life depression, and it is recommended that the efficacy of least the minimal effective dosage should first be determined. Switching antidepressants and aripiprazole augmentation can be used to treatment-resistant therapy. Electroconvulsive therapy and repetitive transcranial magnetic stimulation have demonstrated usefulness for late-life depression. Exercise therapy, high-intensity light therapy, and diet therapy also show some effectiveness and are useful for late-life depression. Continuation therapy should be maintained for at least 1 year after remission.
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Affiliation(s)
- Hajime Baba
- Department of Psychiatry, Juntendo University Koshigaya Hospital, Saitama, Japan.,Department of Psychiatry & Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinsuke Kito
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| | - Kazutaka Nukariya
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan.,Department of Psychiatry, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan
| | - Minoru Takeshima
- Department of Psychiatry, Meishin-kai Shibata Hospital, Toyama, Japan.,Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Noboru Fujise
- Health Care Center, Kumamoto University, Kumamoto, Japan
| | - Junichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Hidehiro Oshibuchi
- Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.,Department of Child Psychiatry, Kanagawa Children's Medical Center, Kanagawa, Japan
| | | | - Mahiko Kimura
- Department of Neuropsychiatry, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan
| | - Katsuyoshi Mizukami
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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17
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Xiao P, Ding S, Duan Y, Li L, Zhou Y, Luo X, Xie J, Cheng AS. Effect of Light Therapy on Cancer-Related Fatigue: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2022; 63:e188-e202. [PMID: 34563631 DOI: 10.1016/j.jpainsymman.2021.09.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022]
Abstract
CONTEXT Light therapy is a non-pharmacological therapy that is currently being studied in cancer-related symptoms and is certificated as a low-risk intervention by FDA. Cancer-related fatigue (CRF) is the most common symptom reported by cancer patients. OBJECTIVE To examine the effectiveness of light therapy for CRF in cancer patients through a systematic review and meta-analysis. METHODS We conducted a systematic review of four electronic databases targeted randomized clinical trials evaluating light therapy for CRF (CRD42020215446), from inception to May 2021. The primary outcome was changes of CRF scores; secondary outcomes included depression, sleep, and quality of life (QoL). We quantitatively pooled outcomes using meta-analysis with random-effects models and assessed methodological bias. RESULTS We identified thirteen RCTs representing 551 cancer patients, encompassing breast (n = 5), ovarian or endometrial (n = 1), multiple myeloma (n = 1), lung (n = 1), or combined (n = 5) cancers. The comparison groups included dim light (n = 12) and waiting list (n = 1). Duration of intervention ranged from 1 to 12 weeks. Light intensities ranged from 417.9 to 12,000 lux. Light therapy was associated with a significant improvement in CRF (SMD = 0.45, P = 0.007), depression (SMD = -0.26, P = 0.03) and sleep difficulty (SMD = -2.46, P = 0.0006); a statistically non-significant trend was observed for QoL (SMD = 0.33, P = 0.09). Funnel plots for CRF suggest not significant publication bias. CONCLUSION Light therapy could be a feasible and effective option for improving CRF in cancer patients. Larger sample, rigor trials design and a standard protocol of intervention are needed to draw more conclusive conclusions.
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Affiliation(s)
- Panpan Xiao
- Xiangya Nursing School (P.X., L.L., Y.Z., X.L.), Central South University, Changsha, Hunan, China
| | - Siqing Ding
- Department of Nursing (S.D., J.X.), The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yinglong Duan
- Department of Emergency (Y.D.), The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lijun Li
- Xiangya Nursing School (P.X., L.L., Y.Z., X.L.), Central South University, Changsha, Hunan, China
| | - Yi Zhou
- Xiangya Nursing School (P.X., L.L., Y.Z., X.L.), Central South University, Changsha, Hunan, China
| | - Xiaofei Luo
- Xiangya Nursing School (P.X., L.L., Y.Z., X.L.), Central South University, Changsha, Hunan, China
| | - Jianfei Xie
- Department of Nursing (S.D., J.X.), The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences (A.S.K.C.), The Hong Kong Polytechnic University, Hong Kong, China
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Kaltenboeck A, Ruzickova T, Breunhölder V, Zghoul T, Cowen PJ, Harmer CJ. No antidepressant-like acute effects of bright light on emotional information processing in healthy volunteers. Psychopharmacology (Berl) 2022; 239:277-286. [PMID: 34743231 PMCID: PMC8770384 DOI: 10.1007/s00213-021-06003-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/12/2021] [Indexed: 01/10/2023]
Abstract
RATIONALE Bright light treatment (BLT) is an efficacious antidepressant intervention, but its mechanism of action is not well understood. Antidepressant drugs acutely affect how emotional information is processed, pushing the brain to prioritise positive relative to negative input. Whether BLT could have a similar effect is not known to date. OBJECTIVE To test whether BLT acutely influences emotional information processing similar to antidepressant drugs, using an established healthy volunteer assay. METHODS Following a double-blind, parallel-group design, 49 healthy volunteers (18-65 years, 26 females) were randomly allocated to 60-min BLT (≥ 10,000 lux) or sham-placebo treatment early in the morning in autumn/winter. Immediately after treatment, emotional information processing was assessed using the Oxford Emotional Test Battery, a validated set of behavioural tasks tapping into emotional information processing in different cognitive domains. Participants also completed questionnaires before and after treatment to assess changes in subjective state. RESULTS The BLT group did not show significantly more positively biased emotional information processing compared to the placebo group (p > 0.05 for all measures). After adjustment for pre-treatment scores, there were also no significant post-treatment differences between groups in subjective state (p > 0.05 for all measures). CONCLUSIONS BLT did not show immediate effects on emotional information processing in an established healthy volunteer assay. Thus, BLT might exert its clinical effects through a different (cognitive) mechanism than other antidepressant interventions. Future studies should corroborate this finding including clinical populations and more intensive treatment regimes, and control for potential chronobiological effects.
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Affiliation(s)
- Alexander Kaltenboeck
- Department of Psychiatry, University of Oxford, Oxford, UK. .,Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
| | - Tereza Ruzickova
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - Veronika Breunhölder
- grid.4305.20000 0004 1936 7988School of Mathematics and Maxwell Institute for Mathematical Sciences, University of Edinburgh, Edinburgh, UK
| | - Tarek Zghoul
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Philip J. Cowen
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Catherine J. Harmer
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK ,grid.416938.10000 0004 0641 5119Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Rodrigues M, Sanger N, Dufort A, Sanger S, Panesar B, D'Elia A, Parpia S, Samaan Z, Thabane L. Outcomes reported in randomised controlled trials of major depressive disorder in older adults: protocol for a methodological review. BMJ Open 2021; 11:e054777. [PMID: 34725082 PMCID: PMC8562520 DOI: 10.1136/bmjopen-2021-054777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Major depressive disorder (MDD or depression) is prevalent among adults aged 65 years and older. The effectiveness and safety of interventions used to treat depression is often assessed through randomised controlled trials (RCTs). However, heterogeneity in the selection, measurement and reporting of outcomes in RCTs renders comparisons between trial results, interpretability and generalisability of findings challenging. There is presently no core outcome set (COS) for use in RCTs that assess interventions for older adults with MDD. We will conduct a methodological review of the literature for outcomes reported in trials for adults 65 years and older with depression to assess the heterogeneity of outcome measures. METHODS AND ANALYSIS RCTs evaluating pharmacotherapy, psychotherapy, or any other treatment intervention for older adults with MDD published in the last 10 years will be located using electronic database searches (MEDLINE, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials). Reviewers will conduct title and abstract screening, full-text screening and data extraction of trials eligible for inclusion independently and in duplicate. Outcomes will be synthesised and mapped to core outcome-domain frameworks. We will summarise characteristics associated with trials and outcomes. ETHICS AND DISSEMINATION We hope that findings from our methodological review will reduce variability in outcome selection, measurement and reporting and facilitate the development of a COS for older adults with MDD. Our review will also inform evidence synthesis efforts in identifying the best treatment practices for this clinical population. Ethics approval is not required, as this study is a literature review. PROSPERO REGISTRATION NUMBER CRD42021244753.
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Affiliation(s)
- Myanca Rodrigues
- Health Research Methodology Graduate Program, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nitika Sanger
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Alexander Dufort
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Sanger
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Balpreet Panesar
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Alessia D'Elia
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Sameer Parpia
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Mood Disorders Program, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
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20
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Kolberg E, Hjetland GJ, Thun E, Pallesen S, Nordhus IH, Husebo BS, Flo-Groeneboom E. The effects of bright light treatment on affective symptoms in people with dementia: a 24-week cluster randomized controlled trial. BMC Psychiatry 2021; 21:377. [PMID: 34320937 PMCID: PMC8317398 DOI: 10.1186/s12888-021-03376-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The majority of people with dementia have behavioral and psychological symptoms of dementia (BPSD), including depression, anxiety and agitation. These may be elicited or aggravated by disrupted circadian rhythms. Bright light treatment (BLT) is a promising non-pharmacological approach to the management of BPSD, but previous research has yielded mixed results. METHODS Eight nursing home dementia units (1 unit = 1 cluster) with 78 patients were invited to participate in a cluster randomized controlled trial from September 2017 to April 2018 investigating the effects of BLT on sleep and circadian rhythms (primary outcome) and BPSD (secondary outcome). Ceiling mounted LED-panels were installed in the intervention group (four units), providing light at 1000 lx and 6000 K (vertically at 1.2 m) between 10 a.m. and 3 p.m., with lower values in the mornings and evenings. Standard indoor light was used in the control group (four units). BPSD were assessed with The Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory Nursing Home Version (NPI-NH). Data collection took place at baseline and after 8, 16 and 24 weeks. Multilevel regression models with and without false discovery rate correction were used for the analysis, with baseline values and dementia stage entered as covariates. RESULTS Sixty-nine patients were included in the study at baseline. Compared to the control group, the intervention group had a larger reduction on the composite scores of both the CSDD (95% CI = - 6.0 - - 0.3) and the NPI-NH (95% CI = - 2.2 - - 0.1), as well as on the NPI-NH Affect sub-syndrome, and the CSDD Mood related signs sub-scale at follow-up after 16 weeks. With FDR correction, the group difference was significant on the CSDD Mood related signs sub-scale (95% CI = - 2.7 - - 0.8) and the NPI-NH Affect sub-syndrome (95% CI = - 1.6 - - 0.2). No differences were found between conditions at weeks 8 or 24. CONCLUSION Compared to the control condition, affective symptoms were reduced after 16 weeks in the group receiving BLT, suggesting BLT may be beneficial for nursing home patients with dementia. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03357328 . Retrospectively registered on November 29, 2017.
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Affiliation(s)
- Eirin Kolberg
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009, Bergen, Norway.
| | - Gunnhild Johnsen Hjetland
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway ,City Department of Health and Care, City of Bergen, Norway
| | - Eirunn Thun
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
| | - Ståle Pallesen
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, Faculty of Psychology, University of Bergen (UiB) Christies gate 12, 5015 Bergen, Bergen, Norway ,grid.412008.f0000 0000 9753 1393Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway ,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Inger Hilde Nordhus
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway ,grid.5510.10000 0004 1936 8921Department of Behavioral Medicine, Faculty of Medicine, University of Oslo, (UiO), Oslo, Norway
| | - Bettina S. Husebo
- grid.7914.b0000 0004 1936 7443Centre for Elderly and Nursing Home Medicine (SEFAS), Department of Global Public Health and Primary Care, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
| | - Elisabeth Flo-Groeneboom
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, Faculty of Psychology, University of Bergen (UiB), Aarstadveien 17, 5009 Bergen, Norway
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21
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[Positive effect of bright light therapy on mood and sleep quality in institutionalized older people]. Rev Esp Geriatr Gerontol 2021; 56:354-360. [PMID: 34330543 DOI: 10.1016/j.regg.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 05/15/2021] [Accepted: 05/20/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Bright light exposure during the day has a positive effect on health and its deficit can cause multiple physiological and cognitive disorders, including depression. The aim of this study was to evaluate the effect of bright light therapy (BLT) on the quality of sleep and mood emotional state; cognitive status, global deterioration and quality of life in institutionalized elderly. MATERIAL AND METHODS This is a study with repeated measures design. Thirty-seven older people admitted to a nursing home. The study lasted 3 weeks. The first week, the reference values were established with the Oviedo Sleep Questionnaire, Yesavage Depression Scale, Mini-Mental, Global Scale of Impairment and European Quality of Life Questionnaire. During the second week, they were exposed to BLT (7,000-10,000lx at eye level) between 9:30 a.m. and 11:00 a.m. During the third week, all the data were re-evaluated. RESULTS All variables improved significantly after the application of light therapy. Sleep (COS) pre-test 4.1±1.49, post-test 4.9±1.46, p: 0.01), mood (pre-test 3.65±2.78, post-test 2.65±2.9, p: 0.01), cognitive state (pre-test 22.72±6.53, post-test 24±5.92, p: 0.001), state of global deterioration (pre-test 3.10±1.26, post-test 2.72±5.92, p: 0.001) and health-related quality of life (pre-test 6.93±1.86, post-test 7.82±1.62, p: 0.001). CONCLUSIONS Sleep quality, mood, cognitive status, global deterioration status and quality of life significantly improved after the application of light bright therapy.
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22
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Li Y, Ru T, Chen Q, Qian L, Luo X, Zhou G. Effects of illuminance and correlated color temperature of indoor light on emotion perception. Sci Rep 2021; 11:14351. [PMID: 34253773 PMCID: PMC8275593 DOI: 10.1038/s41598-021-93523-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/16/2021] [Indexed: 12/01/2022] Open
Abstract
The acute non-image forming (NIF) effects of daytime light on momentary mood had been-although not always-established in the current literature. It still remains largely unknown whether short-time light exposure would modulate emotion perception in healthy adults. The current study (N = 48) was conducted to explore the effects of illuminance (100 lx vs. 1000 lx at eye level) and correlated color temperature (CCT, 2700 K vs. 6500 K) on explicit and implicit emotion perception that was assessed with emotional face judgment task and emotional oddball task respectively. Results showed that lower CCT significantly decreased negative response bias in the face judgment task, with labeling ambiguous faces less fearful under 2700 K vs. 6500 K condition. Moreover, participants responded slightly faster for emotional pictures under 6500 K vs. 2700 K condition, but no significant effect of illuminance or CCT on negativity bias was revealed in the emotional oddball task. These findings highlighted the differential role of illuminance and CCT in regulating instant emotion perception and suggested a task-dependent moderation of light spectrum on negativity bias.
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Affiliation(s)
- Yun Li
- School of Psychology, South China Normal University, Guangzhou, 510631, China.,Lab of Light and Physio-psychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, 510006, China
| | - Taotao Ru
- Lab of Light and Physio-psychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, 510006, China. .,Guangdong Provincial Key Laboratory of Optical Information Materials and Technology & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, 510006, China.
| | - Qingwei Chen
- School of Psychology, South China Normal University, Guangzhou, 510631, China.,Lab of Light and Physio-psychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, 510006, China
| | - Liu Qian
- School of Psychology, South China Normal University, Guangzhou, 510631, China.,Lab of Light and Physio-psychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, 510006, China
| | - Xianghang Luo
- School of Psychology, South China Normal University, Guangzhou, 510631, China
| | - Guofu Zhou
- Lab of Light and Physio-psychological Health, National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, 510006, China.,Guangdong Provincial Key Laboratory of Optical Information Materials and Technology & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, 510006, China
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Pye J, Phillips AJ, Cain SW, Montazerolghaem M, Mowszowski L, Duffy S, Hickie IB, Naismith SL. Irregular sleep-wake patterns in older adults with current or remitted depression. J Affect Disord 2021; 281:431-437. [PMID: 33360364 DOI: 10.1016/j.jad.2020.12.034] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Disturbed sleep and irregular sleep-wake patterns have been associated with poor outcomes in older adults. Sleep regularity however has not been studied in a sample with current or remitted major depression. METHODS 138 participants (63.8±8.6 years; n=27 current major depression, n=64 remitted, and n=47 healthy controls) were monitored using wrist-worn actigraphy. The Sleep Regularity Index (SRI), sleep-wake fragmentation and stability, sleep onset and offset timing, number of awakenings and measures from cosinor analysis were computed. RESULTS Compared with controls, older adults with current depression had lower SRI (p < 0.01), lower relative amplitude (p < 0.05), and higher activity during sleeping and post-midnight hours (p < 0.05). Older adults with remitted depression displayed lower activity during the day (p < 0.05), showed reduced average activity and lower amplitude than controls. Total sleep time, sleep timing, and number of awakenings did not differ between groups. All groups differed significantly in self-reported sleep quality and depression severity. LIMITATIONS Longitudinal studies which examine how sleep-wake patterns change based on depressive episode recency, severity and how medications may influence these patterns are needed. CONCLUSIONS Older adults with current or remitted major depression do not differ from controls on traditional sleep metrics but do report poor quality sleep and show differences in sleep regularity and rest-activity patterns. Reducing the risk of poor outcomes in both groups may be aided by interventions that help promote sleep regularity and increased activity.
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Affiliation(s)
- Jonathon Pye
- Healthy Brain Ageing Program, School of Psychology, University of Sydney, Australia; Susan Wakil School of Nursing and Midwifery, University of Sydney, Australia
| | - Andrew Jk Phillips
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Sean W Cain
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Australia
| | | | - Loren Mowszowski
- Healthy Brain Ageing Program, School of Psychology, University of Sydney, Australia; Brain & Mind Centre, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia; CogSleep Centre of Research Excellence, National Health and Medical Research Council, Australia
| | - Shantel Duffy
- Brain & Mind Centre, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia; CogSleep Centre of Research Excellence, National Health and Medical Research Council, Australia; Faculty of Medicine and Health, University of Sydney, Australia
| | - Ian B Hickie
- Brain & Mind Centre, University of Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, School of Psychology, University of Sydney, Australia; Brain & Mind Centre, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia; CogSleep Centre of Research Excellence, National Health and Medical Research Council, Australia.
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Khan N, Weisenbach SL. Public health efforts toward reducing depression in older people. Int Psychogeriatr 2021; 33:115-116. [PMID: 33750503 DOI: 10.1017/s1041610220003865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Nida Khan
- Northwell Health, Mather Hospital, Department of Psychiatry, 75 N Country Rd., Port Jefferson, NY11777, USA
| | - Sara L Weisenbach
- Stony Brook University, Department of Psychiatry & Behavioral Health, 101 Nicolls Rd., Stony Brook, NY11794, USA
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Xiao M, Feng L, Wang Q, Luan X, Chen S, He J. The therapeutic effects and safety of bright light therapy combined with escitalopram oxalate on insomnia in patients with poststroke depression. Int J Geriatr Psychiatry 2021; 36:182-189. [PMID: 32830332 DOI: 10.1002/gps.5412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 07/17/2020] [Accepted: 08/14/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Bright light therapy (BLT) is known to treat depression and sleep disorders in clinical practice, but its efficacy on poststroke depression (PSD) has not been studied. OBJECTIVE To investigate the therapeutic effects and safety of BLT combined with escitalopram oxalate (ESC) on insomnia in patients with PSD. METHODS Ischemic stroke patients with depressive symptoms and a score of ≥8 on the Hamilton Depression Scale (HAMD-17) while meeting DSM-IV criteria were diagnosed as having PSD. A total of 112 PSD patients with symptoms of insomnia were randomly assigned to polytherapy (BLT plus ESC) and monotherapy (ESC only) groups. Each regimen continued for 6 weeks. The primary outcomes were a change in scores on the Pittsburgh Sleep Quality Index (PSQI) and a remission rate (PSQI ≤7 at the endpoint). The secondary outcomes included changes in the HAMD-17 and Barthel Index (BI) scores. Adverse effects were assessed by the Adverse Events Scale. RESULTS The endpoint assessment included 106 patients (monotherapy, 54; polytherapy, 52). The mean changes in the PSQI scores for the monotherapy and polytherapy groups were 4.85 (1.47) and 5.87 (1.72) (P = 0.001), respectively. Compared to monotherapy, polytherapy improved PSQI remission rate (71.4% vs 50.0%; χ2 = 5.390; P = 0.020), and HAMD-17 score (6.70 [2.12] vs 4.75 [1.98]; P < 0.001). Both treatments improved BI score, with no statistical difference, and were well tolerated, with few significant differences in treatment-associated adverse events. CONCLUSION BLT combined with ESC is effective and well tolerated for the treatment of PSD-associated insomnia.
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Affiliation(s)
- Meijuan Xiao
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liang Feng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qiongzhang Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoqian Luan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Siyan Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Trkulja V, Barić H. Current Research on Complementary and Alternative Medicine (CAM) in the Treatment of Major Depressive Disorder: An Evidence-Based Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:375-427. [PMID: 33834410 DOI: 10.1007/978-981-33-6044-0_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Complementary and alternative medicine (CAM) encompasses a wide range of different non-mainstream therapies that have been increasingly used for treatment or adjunctive treatment of various ailments with mood disorders and "depressive difficulties" being two of the commonly CAM (self-)medicated conditions. We focus specifically on clinically diagnosed (in line with the standard criteria) depressive disorders, primarily major depressive disorder (MDD), and overview evidence of efficacy/safety of a range of CAM modalities addressing exclusively randomized controlled trials (RCTs) and systematic reviews/meta-analyses of RCTs. The list of addressed CAM interventions is not exhaustive: due to space limitation, addressed are interventions with at least a few conducted RCTs in the specific clinical conditions. We try to provide numerical and meaningful data as much as it is possible and to (a) indicate situations in which the reported data/estimates might have been "too enthusiastic" and (b) warn about heterogeneity of results that, together with other possible limitations (various biases and imprecision), results in uncertainty about the effects.
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Affiliation(s)
- Vladimir Trkulja
- Department of Pharmacology, Zagreb University School of Medicine, Zagreb, Croatia.
| | - Hrvoje Barić
- Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
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Efficacy of light therapy for a college student sample with non-seasonal subthreshold depression: An RCT study. J Affect Disord 2020; 277:443-449. [PMID: 32871530 DOI: 10.1016/j.jad.2020.08.055] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/17/2020] [Accepted: 08/21/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND Light therapy has been successfully used to treat seasonal and non-seasonal depression, but there is limited evidence for its efficacy in subthreshold depression. This study examines the efficacy of light therapy for symptoms of depression and anxiety in non-seasonal subthreshold depression. METHODS College students with non-seasonal subthreshold depression were recruited. The participants were randomly allocated to one of the three conditions: high- (LT-5000 lux) and low-intensity (LT-500 lux) light therapy conditions and a waiting-list control condition (WLC). The primary outcome was Hamilton Depression Rating Scale (HAMD), and secondary outcomes were Beck Depression Inventory-II (BDI-II) and state anxiety inventory (SAI), which were assessed at baseline (Week 0), during the trial (Week 4), and after completion of the light therapy (Week 8). RESULTS A total of 142 participants completed the trial. The LT-5000 (effect size [d] = 1.56, 95% CI: 1.15 to 1.98) and LT-500 conditions (d = 0.84, 95% CI: 0.43 to 1.26) were significantly superior to the WLC condition. For the LT-5000, LT-500, and WLC conditions by the end of the 8-week trial, a response on the HAMD was achieved by 70.0%, 42.0% and 19.0% of the participants, and remission was achieved by 76.0%, 54.0%, and 19.0%, respectively. LIMITATIONS The subjects were not followed up regularly after completion of the trial. CONCLUSION Light therapy, both at high- and low-intensity, was efficacious in the treatment of college students with non-seasonal subthreshold depression. High-intensity light therapy was superior to low-intensity light therapy by the end of an 8-week trial.
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Effects of tobacco addiction on links between early life adversities, sleep disturbance, and depression: A moderated mediation approach. Prev Med Rep 2020; 20:101225. [PMID: 33194536 PMCID: PMC7642869 DOI: 10.1016/j.pmedr.2020.101225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 09/09/2020] [Accepted: 10/10/2020] [Indexed: 11/22/2022] Open
Abstract
Despite the well-established relationship between early life adversities (ELA) and depression, the underlying mechanisms for this link remain less clear and need to be developed. The aim of this study was to advance our understanding of this link by testing the mediating role of sleep disturbances and the moderating role of tobacco use in this mediation. A total of 579 smokers and non-smokers were recruited in two US communities (Duluth and Minneapolis, MN). Simple and moderated mediation analyses were performed using the PROCESS macro for SPSS, with the number of ELA as an independent variable, depression symptoms assessed by the Patient Health Questionnaire-9 (PHQ-9) as a dependent variable, sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI) as a mediator, and smoking status as a moderator variable. The study demonstrated that ELA and depressive symptoms were positively correlated; and sleep quality fully mediated this relationship. This mediation was moderated by tobacco use (index of moderated mediation = 0.10, 95%CI [0.03; 0.19]) and was more pronounced among smokers (b = 0.14, 95%CI [0.07; 0.23]) than non-smokers (b = 0.04, 95%CI [0.0002; 0.10]). Subsequent mediation analyses run separately for each component of the PSQI suggested that individuals who experienced ELA and who were smokers had greater delays in sleep onset and were more likely to sleep for a shorter duration, both of which predicted greater depressive symptoms. Sleep quality is therefore a promising ELA-related target for preventive and therapeutic interventions as well as for further research in depression and tobacco addiction.
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Takeshima M, Utsumi T, Aoki Y, Wang Z, Suzuki M, Okajima I, Watanabe N, Watanabe K, Takaesu Y. Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta-analysis. Psychiatry Clin Neurosci 2020; 74:247-256. [PMID: 31917880 PMCID: PMC7187384 DOI: 10.1111/pcn.12976] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/30/2019] [Accepted: 12/17/2019] [Indexed: 02/06/2023]
Abstract
AIM This systematic review and meta-analysis evaluated whether bright light therapy (BLT) is an effective and safe treatment for manic/depressive symptoms and a preventive measure for recurrent mood episodes in patients with bipolar disorder. METHODS A literature search of major electronic databases was conducted in June 2019, including all published articles up to that date. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. RESULTS Six randomized controlled trials (RCT) evaluated the efficacy of BLT for bipolar depression. A meta-analysis found no significant differences between BLT and placebo for the following outcomes: (i) rates of remission from depressive episodes (risk ratio [RR]: 1.81, 95% confidence interval [CI]: 0.43 to 7.64, P = 0.42); (ii) depressive symptom scores (standardized mean difference: -0.25, 95%CI: -0.74 to 0.23, P = 0.30); and (iii) rates of manic switching (RR: 1.00, 95%CI: 0.28 to 3.59, P = 0.26). The sensitivity analysis for studies with low overall indirectness did show a significant antidepressant effect for BLT (RR: 3.09, 95%CI: 1.62 to 5.90, P = 0.006). No RCT investigated the effect of BLT in preventing the recurrence of mood episodes in the euthymic state or in improving manic symptoms in the manic state. No severe adverse events were reported. CONCLUSION While a meta-analysis was unable to demonstrate the efficacy of BLT for bipolar depression, a sensitivity analysis did show a significant effect. Further well-designed studies are needed to clarify the effectiveness of BLT, not only for the depressive state but also for other states, in the treatment of bipolar disorder.
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Affiliation(s)
- Masahiro Takeshima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
| | - Tomohiro Utsumi
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
| | - Yumi Aoki
- Psychiatric & Mental Health Nursing, St. Luke's International University, Tokyo, Japan
| | - Zhe Wang
- Renaissance School of Medicine at Stony Brook University, New York, USA
| | - Masahiro Suzuki
- Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
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Winterbottom FA, LeBlanc-Lucas K, Boylan A. Nurses' Influence on Patient Wellbeing: Noise Reduction and Sunshine Therapy. Crit Care Nurs Clin North Am 2020; 32:327-334. [PMID: 32402325 DOI: 10.1016/j.cnc.2020.02.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes 2 nurse-driven programs that aimed to improve patient wellbeing and decrease ICU stressors to improve the ICU experience. One program addressed noise reduction and the other describes Sunshine Therapy.
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Affiliation(s)
- Fiona A Winterbottom
- Critical Care Medicine, Ochsner Medical Center, 1514, Jefferson Highway, New Orleans, LA 70121, USA.
| | | | - Alexandra Boylan
- CMICU, Ochsner Medical Center, 1514, Jefferson Highway, New Orleans, LA 70121, USA
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Efficacy of light therapy versus antidepressant drugs, and of the combination versus monotherapy, in major depressive episodes: A systematic review and meta-analysis. Sleep Med Rev 2019; 48:101213. [DOI: 10.1016/j.smrv.2019.101213] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 08/24/2019] [Accepted: 09/10/2019] [Indexed: 01/19/2023]
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Maruani J, Geoffroy PA. Bright Light as a Personalized Precision Treatment of Mood Disorders. Front Psychiatry 2019; 10:85. [PMID: 30881318 PMCID: PMC6405415 DOI: 10.3389/fpsyt.2019.00085] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 02/06/2019] [Indexed: 01/10/2023] Open
Abstract
Background: The use of light for its antidepressant action dates back to the beginnings of civilization. Three decades ago, the use of bright-light therapy (BLT) for treating Seasonal Affective Disorder (SAD) was officially proposed. Since then, a growing scientific literature reports its antidepressant efficacy in both unipolar and bipolar disorders (BD), with or without seasonal patterns. This review aims to examine the management of BLT as a personalized and precision treatment in SAD, unipolar, and BD. Methods: We conducted a narrative review using Medline and Google Scholar databases up to June 2018. Results: BLT has physiological effects by resynchronizing the biological clock (circadian system), enhancing alertness, increasing sleep pressure (homeostatic system), and acting on serotonin, and other monoaminergic pathways. Effects of BLT on mood depend on several factors such as light intensity, wavelength spectrum, illumination duration, time of the day, and individual circadian rhythms. A growing body of evidence has been generated over the last decade about BLT evolving as an effective depression treatment not only to be used in SAD, but also in non-seasonal depression, with efficiency comparable to fluoxetine, and possibly more robust in patients with BD. The antidepressant action of BLT is fast (within 1-week) and safe, with the need in BD to protect against manic switch with mood stabilizers. Side effects might be nausea, diarrhea, headache, and eye irritation, and are generally mild and rare. This good safety profile may be of particular interest, especially in women during the perinatal period or for the elderly. The management of BLT needs to be clarified across mood disorders and future studies are expected to compare different dose-titration protocols, to validate its use as a maintenance treatment, and also to identify predictive biomarkers of response and tolerability. We propose clinical guidelines for BLT use in SAD, non-seasonal depression, and BD. Conclusions : BLT is an efficient antidepressant strategy in mono- or adjunct-therapy, that should be personalized according the unipolar or bipolar subtype, the presence or absence of seasonal patterns, and also regarding its efficacy and tolerability.
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Affiliation(s)
- Julia Maruani
- Inserm, U1144, Paris, France.,Université Paris Descartes, UMR-S 1144, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.,AP-HP, GH Saint-Louis-Lariboisière-F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France
| | - Pierre Alexis Geoffroy
- Inserm, U1144, Paris, France.,Université Paris Descartes, UMR-S 1144, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France.,AP-HP, GH Saint-Louis-Lariboisière-F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Paris, France
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Yoon YS, Lee CK, Kang SO, Kim SW. Comparison of Contrast Sensitivity and Color Vision according to the Different Illumination in Patients with Cataract. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.7.622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yo Sep Yoon
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Chang Kyu Lee
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sang Ook Kang
- Department of Materials Chemistry, Korea University College of Science and Technology, Sejong, Korea
| | - Sang Woo Kim
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Chang CH, Liu CY, Chen SJ, Tsai HC. Efficacy of light therapy on nonseasonal depression among elderly adults: a systematic review and meta-analysis. Neuropsychiatr Dis Treat 2018; 14:3091-3102. [PMID: 30532540 PMCID: PMC6241691 DOI: 10.2147/ndt.s180321] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the effectiveness of light therapy in the treatment of geriatric depression. METHODS A systematic review and meta-analysis were carried out. Data sources for the literature search were PubMed, Cochrane Collaboration's Central Register of Controlled Clinical Trials, Cochrane Systematic Reviews, and ClinicalTrials.gov. Controlled trials of light therapy on older patients with nonseasonal depression and depression rating scales were eligible. Studies were pooled using a random-effect model for comparisons with light therapy. We used effect size (ES), which expresses changes in depression severity, in each selected meta-analysis to calculate the standardized mean difference on the basis of Hedges' adjusted g; positive values indicated that the depression severity improved after light therapy. All results were presented with 95% CIs. Statistical heterogeneity was explored through visual inspection of funnel plots and the I2 statistic. Moderators of effects were explored using meta-regression. RESULTS We identified eight trials involving 395 participants that met the inclusion criteria. Light therapy was significantly more effective than comparative treatments, including placebo or dim light, with an ES of 0.422 (95% CI: 0.174-0.709, P=0.001). In addition, six of the eight trials used bright (white) light, resulting in significantly reduced severity of geriatric depression (N=273, ES: 0.460, 95% CI: 0.085-0.836, P=0.016). Furthermore, pale blue light therapy reduced the severity of geriatric depression (N=89, ES: 0.464, 95% CI: 0.046-0.882, P=0.030). CONCLUSION Our results highlighted the significant efficacy of light therapy in the treatment of geriatric depression. Additional well-designed, controlled studies are necessary to adopt standard parameters, adequate group sizes, and randomized assignment to evaluate more thoroughly the efficacy of light therapy for treating geriatric depression.
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Affiliation(s)
- Chun-Hung Chang
- Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Chieh-Yu Liu
- Biostatistical Consulting Laboratory, Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shaw-Ji Chen
- Department of Psychiatry, Mackay Memorial Hospital Taitung Branch, Taitung, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei, Taiwan
| | - Hsin-Chi Tsai
- Department of Psychiatry, Tzu-Chi General Hospital, Hualien City, Taiwan, .,Department of Psychiatry, School of Medicine, Tzu-Chi University, Hualien City, Taiwan,
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