Intervention Review

Light therapy for non-seasonal depression

  1. Arja Tuunainen1,*,
  2. Daniel F Kripke2,
  3. Takuro Endo3

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 2 JAN 2004

DOI: 10.1002/14651858.CD004050.pub2

Database Title

Additional Information

How to Cite

Tuunainen A, Kripke DF, Endo T. Light therapy for non-seasonal depression. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD004050. DOI: 10.1002/14651858.CD004050.pub2.

Author Information

  1. 1

    University of Helsinki, Department of Psychiatry, Hus, Finland

  2. 2

    Scripps Clinic Sleep Center, La Jolla, CA, USA

  3. 3

    Aoki Hospital, Tokyo, Japan

*Arja Tuunainen, Department of Psychiatry, University of Helsinki, Lapinlahdentie, P.O.Box 320, Hus, FIN 00029, Finland. arja.tuunainen@helsinki.fi.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 8 JUL 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Efficacy of light therapy for non-seasonal depression has been studied without any consensus on its efficacy.

Objectives

To evaluate clinical effects of light therapy in comparison to the inactive placebo treatment for non-seasonal depression.

Search methods

We searched the Depression Anxiety & Neurosis Controlled Trials register (CCDANCTR January 2003), comprising the results of searches of Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 -), EMBASE (1980 -), CINAHL (1982 -), LILACS (1982 -), National Research Register, PsycINFO/PsycLIT (1974 -), PSYNDEX (1977 -), and SIGLE (1982 - ) using the group search strategy and the following terms: #30 = phototherapy or ("light therapy" or light-therapy). We also sought trials from conference proceedings and references of included papers, and contacted the first author of each study as well as leading researchers in the field.

Selection criteria

Randomised controlled trials comparing bright light with inactive placebo treatments for non-seasonal depression.

Data collection and analysis

Data were extracted and quality assessment was made independently by two reviewers. The authors were contacted to obtain additional information.

Main results

Twenty studies (49 reports) were included in the review. Most of the studies applied bright light as adjunctive treatment to drug therapy, sleep deprivation, or both. In general, the quality of reporting was poor, and many reviews did not report adverse effects systematically. The treatment response in the bright light group was better than in the control treatment group, but did not reach statistical significance. The result was mainly based on studies of less than 8 days of treatment. The response to bright light was significantly better than to control treatment in high-quality studies (standardized mean difference (SMD) -0.90, 95% confidence interval (CI) -1.50 to -0.31), in studies applying morning light treatment (SMD -0.38, CI -0.62 to -0.14), and in sleep deprivation responders (SMD -1.02, CI -1.60 to -0.45). Hypomania was more common in the bright light group compared to the control treatment group (risk ratio 4.91, CI 1.66 to 14.46, number needed to harm 8, CI 5 to 20).

Authors' conclusions

For patients suffering from non-seasonal depression, light therapy offers modest though promising antidepressive efficacy, especially when administered during the first week of treatment, in the morning, and as an adjunctive treatment to sleep deprivation responders. Hypomania as a potential adverse effect needs to be considered. Due to limited data and heterogeneity of studies these results need to be interpreted with caution.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Light treatment for non-seasonal depression

The reviewers conclude that the benefit of light treatment is modest though promising for non-seasonal depression. The short-term treatment as well as light administered in the morning and with concomitant sleep deprivation in sleep deprivation responders appear to be most beneficial for treatment response. Hypomania as a potential adverse effect needs to be considered. Due to limited data and heterogeneity of studies these results need to be interpreted with caution.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

非季節性憂鬱症的光照治療

對非季節性憂鬱症的光照治療的效果，目前的研究並沒有共識。

目標

評估光照治療與其他非活性的安慰劑治療，對於非季節性憂鬱症的臨床效果。

搜尋策略

我們以團體搜尋策略與以下關鍵字(phototherapy或 “light therapy” 或 lighttherapy)搜尋the Depression Anxiety & Neurosis Controlled Trials register (CCDANCTR 2003年1月), 包括搜尋以下資料庫的結果：Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966年以後), EMBASE (1980年以後), CINAHL (1982年以後), LILACS (1982年以後), National Research Register, PsycINFO/PsycLIT (1974以及SIGLE (1982年以後)。我們也從會議論文、文章的參考文獻搜尋試驗，並且與每個研究的第一作者以及此領域的主要研究者聯絡。

選擇標準

對非季節性憂鬱症患者，比較明亮的光照與非活性的安慰劑治療的隨機對照試驗。

資料收集與分析

由兩位回顧者獨立地擷取資料並評估其品質。聯繫作者們以得到額外的資訊。

主要結論

回顧納入20個研究(49份報告)。大部分的研究使用光照治療作為藥物治療、睡眠剝奪或兩者的附加治療。一般來說，報告的品質不佳，許多回顧也沒有系統性地報告副作用。光照治療組的治療反應比控制組要好，但沒有達到統計學上的顯著差異。結果主要是基於少於8天的治療的研究。對光照治療的反應顯著地比控制組要好，不管是在高品質的研究中(標準化的平均差(SMD) −0.90, 95% 信賴區間(CI) −1.50 至 −0.31)，在早晨進行光照治療的研究(SMD −0.38, CI −0.62 至 −0.14)，在睡眠剝奪的參與者(SMD −1.02, CI −1.60 至 −0.45)。輕躁症在光照治療組比在控制治療組要多(風險比率 4.91, CI 1.66 至 14.46, 害一需治數 8, CI 5 至 20). 。

作者結論

對於非季節性憂鬱症的患者，光照治療提供中度但有希望的抗憂鬱效果，尤其是在治療的第一週實施，在早晨實施，以及作為睡眠剝奪的一種附加治療。輕躁症是可能的副作用，需要納入考量。由於研究的資料有限以及其異質性，在解釋這些結果時需要小心。

翻譯人

本摘要由彰化基督教醫院陳美雀翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

這篇回顧找到對非季節性憂鬱症患者比較光照治療及控制(安慰劑)治療的隨機對照試驗。回顧者的結論是光照治療對非季節性憂鬱症患者的效益是中度但有希望的。短期的治療以及在早晨實施的光照，加上相伴隨的睡眠剝奪看起來最有治療反應。輕躁症是一種可能的副作用，需要考量。由於研究的資料有限以及其異質性，在解釋這些結果時需要小心。

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