scholarly journals 100,000 lumens to treat seasonal affective disorder: A proof of concept RCT of bright, whole-room, all-day (BROAD) light therapy

2021 ◽  
Author(s):  
Julia Fabienne Sandkuehler ◽  
Sarah Brochhagen ◽  
Rosa Clara Muscheidt ◽  
Teja Wolfgang Groemer ◽  
Helge Mueller ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Rating Scale ◽  
Seasonal Affective Disorder ◽  
Therapy Group ◽  
Standard Of Care ◽  
Light Therapy ◽  
Self Report ◽  
Symptom Improvement ◽  
Proof Of Concept

Background. Seasonal affective disorder (SAD) is common and debilitating. The standard of care includes light therapy provided by a light box; however, this treatment is restrictive and only moderately effective. Advances in LED technology enable lighting solutions that emit vastly more light than traditional light boxes. Here, we assess the feasibility of BROAD (Bright, whole-ROom, All-Day) light therapy and get a first estimate for its potential effectiveness. Methods. Patients were randomly assigned to a treatment for four weeks; consisting of either a very brightly illuminated room in their home for at least six hours per day (BROAD light therapy) or 30 minutes in front of a standard 10,000 lux SAD light box. Feasibility was assessed by monitoring recruitment, adherence, and side effects. SAD symptoms were measured at baseline and after two and four weeks, with the Hamilton Depression Rating Scale-Seasonal Affective Disorders 29-items, self-report version. Results. All 62 patients who started treatment were available at four-week follow-up and no significant adverse effects were reported. SAD symptoms of both groups improved similarly and considerably, in line with previous results. Exploratory analyses indicate that a higher illuminance (lux) is associated with a larger symptom improvement in the BROAD light therapy group. Conclusions. BROAD light therapy is feasible and seems similarly effective as the standard of care while not confining the participants to 30 minutes in front of the light box. In follow-up trials, it should be modified for increased illuminance, possibly increasing its effectiveness over that of light box treatment.

L-Tryptophan Augmentation of Light Therapy in Patients with Seasonal Affective Disorder

1997 ◽  
Vol 42 (3) ◽  
pp. 303-306 ◽  
Author(s):  
Raymond W Lam ◽  
Robert D Levitan ◽  
Edwin M Tam ◽  
Lakshmi N Yatham ◽  
Sophie Lamoureux ◽  
...  
Keyword(s):  
Side Effects ◽  
Affective Disorder ◽  
Rating Scale ◽  
Seasonal Affective Disorder ◽  
Combined Treatment ◽  
Light Therapy ◽  
Structured Interview ◽  
Fluorescent Light ◽  
Open Label ◽  
Augmentation Strategy

Objective Up to one-third of patients with seasonal affective disorder (SAD) do not have a full response to light therapy. Given the evidence for serotonergic dysregulation in SAD, we examined the possible role of l-tryptophan as an augmentation strategy for nonresponders and partial responders to light therapy. Method Eligible drug-free patients meeting DSM-IV criteria for SAD were treated for 2 weeks using a standard morning light therapy regimen (10 000 lux cool-white fluorescent light for 30 minutes). Partial and nonresponders were treated for 2 weeks with open-label l-tryptophan (1 g 3 times daily) while light therapy was continued. Ratings at baseline and follow-up included the 29-item Structured Interview Guide for the Hamilton Depression Rating Scale, SAD version (SIGH-SAD) and the Clinical Global Impression (CGI) scale. Results Sixteen patients began the l-tryptophan augmentation phase. Two patients discontinued medications within 3 days because of side effects. In the 14 patients completing treatment, the addition of l-tryptophan resulted in significant reduction of mean depression scores. Nine of 14 patients (64%) showed very good clinical responses to combined treatment and minimal side effects. Conclusion This open-label study suggests that l-tryptophan may be an effective augmentation strategy for those patients with SAD who show limited or poor response to bright light therapy. Further placebo-controlled studies are warranted to demonstrate efficacy.

Light therapy increases visual contrast sensitivity in seasonal affective disorder

2004 ◽  
Vol 126 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Zoltán Szabó ◽  
Andrea Antal ◽  
Zsolt Tokaji ◽  
János Kálmán ◽  
Szabolcs Kéri ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Contrast Sensitivity ◽  
Seasonal Affective Disorder ◽  
Light Therapy ◽  
Visual Contrast ◽  
Visual Contrast Sensitivity

COGNITIVE BEHAVIOUR THERAPY AND ASSERTION TRAINING GROUPS FOR PATIENTS WITH DEPRESSION AND COMORBID PERSONALITY DISORDERS

2000 ◽  
Vol 28 (1) ◽  
pp. 71-85 ◽  
Author(s):  
Jillian Ball ◽  
Brian Kearney ◽  
Kay Wilhelm ◽  
Jodie Dewhurst-Savellis ◽  
Belinda Barton
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Depressive Symptomatology ◽  
Therapy Group ◽  
Self Report ◽  
Cognitive Behaviour ◽  
Long Term Follow Up ◽  
Assertion Training

Longitudinal evaluations were conducted on 61 adults who were referred to a Mood Disorders Unit with a history of depression (all index episodes reached criteria for DSM-III-R major depression or dysthymia) and who had completed a cognitive behavioural therapy group either on its own or in combination with an assertion training group. Assessment of personality was made using DSM-III-R Axis II personality disorder categories. These categories were aggregated to form three groups: (i) no personality disorder; (ii) Cluster B (dramatic-erratic); and (iii) Cluster C (anxious-fearful), and were used to identify responsiveness to treatment and outcome at long-term follow-up. A battery of self-report measures were administered pretreatment, posttreatment and at long-term follow-up (1–3 years later). Both groups showed significant improvements in mean scores during treatment and these gains were maintained over the follow-up period. However, improvement in those patients without personality disorders was greater at posttreatment and at long-term follow-up, both in level of depressive symptomatology and proportion of cases meeting criteria for recovery. The treatment implications of these results are discussed.

Light Therapy for Seasonal Affective Disorder the Effects of Timing

1995 ◽  
Vol 166 (5) ◽  
pp. 607-612 ◽  
Author(s):  
Y. Meesters ◽  
J. H. C. Jansen ◽  
D. G. M. Beersma ◽  
A. L. Bouhuys ◽  
R. H. Van Den Hoofdakker
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Response Rates ◽  
Light Therapy ◽  
Light Treatment ◽  
Therapeutic Outcome ◽  
Short Term ◽  
Rank Ordering ◽  
Term Rank

BackgroundSixty-eight patients with seasonal affective disorder participated in a 10 000-lux light treatment study in which two questions were addressed: do response rates differ when the light is applied at different times of the day and does short-term rank ordering of morning and evening light influence response rates?MethodThree groups of patients received a 4-day light treatment: (I) in the morning (8.00–8.30 a.m., n = 14), (II) in the afternoon (1.00–1.30 p.m., n = 15) or (III) in the evening (8.00–8.30 p.m., n = 12). Two additional groups of patients received two days of morning light treatment followed by two days of evening light (IV, n = 13) or vice versa (V, n = 14).ResultsResponse rates for groups I, II and III were 69, 57 and 80% respectively, with no significant differences between them. Response rates for groups IV and V were 67 and 50% respectively; this difference was not significant and these percentages did not differ significantly from those of groups I and III.ConclusionsThe results indicate that the timing of light treatment is not critical and that short-term rank ordering of morning and evening light does not influence therapeutic outcome.

Melatonine en stemmingsstoornissen

1995 ◽  
Vol 7 (3) ◽  
pp. 75-79
Author(s):  
J. Beullens
Keyword(s):  
Pineal Gland ◽  
Affective Disorder ◽  
Premenstrual Syndrome ◽  
Affective Disorders ◽  
Seasonal Affective Disorder ◽  
Bright Light ◽  
Light Therapy ◽  
Melatonin Level ◽  
Melatonin Secretion ◽  
The Relationship

SummaryMelatonin is a hormone secreted by the pineal gland mainly during the night. The discovery that this melatonin secretion decreases under the influence of bright light, gave rise to the use of light therapy in some affective disorders. The literature on the relationship between melatonin secretion and mood is reviewed concerning seasonal affective disorder, non-seasonal affective disorder and premenstrual syndrome. Light therapy could reduce an abnormal high melatonin secretion back to normal proportions. None of the affective disorders, however, is accompanied by an unusual high melatonin level. Nevertheless, light therapy as well as other therapies that suppress melatonin have a therapeutic effect. This is not the case with the administration of melatonin. Mood is not affected by extra melatonin in seasonal affective disorder but it is in both other affective disorders. Melatonin plays a part in the pathogenesis of the affective disorders but it is not yet clear which one.

The Diagnosis, Symptomatology, and Epidemiology of Seasonal Affective Disorder

CNS Spectrums ◽  
2005 ◽  
Vol 10 (8) ◽  
pp. 625-634 ◽  
Author(s):  
Andres Magnusson ◽  
Timo Partonen
Keyword(s):  
Affective Disorder ◽  
Seasonal Affective Disorder ◽  
Bright Light ◽  
Light Therapy ◽  
International Classification Of Diseases ◽  
Emotional Symptoms ◽  
Diagnostic And Statistical Manual ◽  
Northern Latitudes ◽  
Classification Of Diseases ◽  
Operational Criteria

AbstractThe operational criteria for seasonal affective disorder (SAD) have undergone several changes since first proposed in 1984. SAD is currently included as a specifier of either bipolar or recurrent major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The International Classification of Diseases, Tenth Edition has provisional diagnostic criteria for SAD. The most characteristic quality of SAD is that the symptoms usually present during winter and remit in the spring. Furthermore, the symptoms tend to remit when the patients are exposed to daylight or bright light therapy. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite. SAD is a common condition, but the exact prevalence rates vary between different studies and countries and is consistently found to be more common in women and in youth. SAD probably possibly occurs in children although not as commonly as in young adults. Some studies have found that certain ethnic groups who live at high northern latitudes may have adapted to the long arctic winter.

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