Studie úČinnosti světelné terapie 1981 2008 pramen: PubMed – service of the U. S. National Library of Medicine and the National Institutes of Health




НазваниеStudie úČinnosti světelné terapie 1981 2008 pramen: PubMed – service of the U. S. National Library of Medicine and the National Institutes of Health
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2,000 lux), and a 20-min nap. From 13:10 to 16:10, the tasks were repeated six times with the baseline lighting. To measure mood status, multiple visual analogue scales (to measure anxiety, sadness, anger, confusion, apathy, fatigue, and sleepiness) and the Mood Check List 3 (MCL-3) (to derive "pleasantness", "satisfaction" and "relaxation") were employed. The results showed that brief (30 min) natural bright light exposure improved one dimension of mood status, "pleasantness". A short nap also improved dimensions of mood status ("pleasantness", "satisfaction", and "relaxation"). These results suggest that the proper application of both natural light and a short nap shifts the mood status to the positive/favorable side.


Clinical Trial

Research Support, Non-U.S. Gov't

PMID: 17485875


20: Psychol Aging. 2007 Mar;22(1):18-27.


Comment in:

Psychol Aging. 2007 Mar;22(1):52-5.

Evidence-based psychological treatments for insomnia in older adults.

McCurry SM, Logsdon RG, Teri L, Vitiello MV.

Department of Psychosocial and Community Health, University of Washington,

Seattle, WA 98115-2053, USA. smccurry@u.washington.edu

The review describes evidence-based psychological treatments (EBTs) for insomnia in older adults. Following coding procedures developed by the American Psychological Association's Committee on Science and Practice of the Society for Clinical Psychology, two treatments were found to meet EBT criteria: sleep restriction-sleep compression therapy and multicomponent cognitive-behavioral therapy. One additional treatment (stimulus control therapy) partially met criteria, but further corroborating studies are needed. At the present time, there is insufficient evidence to consider other psychological treatments, including cognitive therapy, relaxation, and sleep hygiene education, as stand-alone interventions beneficial for treating insomnia in older adults. Additional research is also needed to examine the efficacy of alternative-complementary therapies, such as bright light therapy, exercise, and massage. This review highlights potential problems with using coding procedures proposed in the EBT coding manual when reviewing the existing insomnia literature. In particular, the classification of older adults as persons age 60 and older and the lack of rigorous consideration of medical comorbidities warrant discussion in the future. (© 2007 APA, all rights reserved).


Research Support, N.I.H., Extramural

Review

PMID: 17385979


21: CNS Spectr. 2007 Feb;12(2 Suppl 2):1-14; quiz 15.


Recent advances in the treatment and management of excessive daytime sleepiness.

Black J, Duntley SP, Bogan RK, O'Malley MB.

Stanford Sleep Medicine Center, Stanford University, Palo Alto, CA, USA.

Excessive daytime sleepiness (EDS) is a prevalent complaint among patients in psychiatric care. Patients with conditions of EDS have often been misdiagnosed with depression due to their complaints of lack of energy, poor concentration, memory disturbance, and a reduced interest in life. Impaired alertness associated with EDS can be detrimental to a person's quality of life by causing decreased work performance, self-consciousness, low self esteem, and social isolation. Excessive sleepiness is also associated with various health problems, comorbid medical and psychiatric conditions, and fatal accidents occurring after the driver has fallen asleep at the wheel. Contributing factors leading to EDS range from insufficient sleep hours to central nervous system-mediated debilitating hypersomnolence. Circadian rhythm disorders, sleep disorders such as obstructive sleep apnea and narcolepsy, and medications that cause sleepiness may also contribute to symptoms of EDS. Recognition of the symptoms of sleep deprivation is essential, as many such patients do not have a clear awareness of their own sleepiness. Treatment options, depending upon the condition, include light therapy or appropriate airway management techniques such as nasal continuous positive airway pressure (CPAP). Occasionally, wakefulness-promoting medications are necessary, particularly in patients with narcolepsy. In this expert roundtable supplement, Stephen P. Duntley, MD, reviews the definition and prevalence of EDS and discusses the contributing factors and consequences of daytime sleepiness. Next, Richard K. Bogan, MD, FCCP, gives an overview of the differential diagnosis of EDS and the assessment tools available for identifying sleepiness in symptomatic patients. Finally, Mary B. O'Malley, MD, PhD, reviews treatment of EDS, including counseling on sleep hygiene and duration of sleep, mechanical treatments, bright-light therapy, and wake-promoting medications.


Research Support, Non-U.S. Gov't

PMID: 17277717


22: J Clin Psychiatry. 2007 Feb;68(2):337-8.


Delayed sleep phase syndrome, ADHD, and bright light therapy.

Gruber R, Grizenko N, Joober R.


Case Reports

Letter

PMID: 17335340


23: Cardiovasc Diabetol. 2007 Jan 15;6:1.


Walking behaviour and glycemic control in type 2 diabetes: seasonal and gender differences—study design and methods.

Dasgupta K, Chan C, Da Costa D, Pilote L, De Civita M, Ross N, Strachan I, Sigal R, Joseph L.

Department of Medicine, Division of Clinical Epidemiology, McGill University

Health Centre, 687 Pine Avenue West, Montreal, Canada. kaberi.dasgupta@mcgill.ca

BACKGROUND: The high glucose levels typically occurring among adults with type 2 diabetes contribute to blood vessel injury and complications such as blindness, kidney failure, heart disease, and stroke. Higher physical activity levels are associated with improved glycemic control, as measured by hemoglobin A1C. A 1% absolute increase in A1C is associated with an 18% increased risk for heart disease or stroke. Among Canadians with type 2 diabetes, we postulate that declines in walking associated with colder temperatures and inclement weather may contribute to annual post-winter increases in A1C levels. METHODS: During this prospective cohort study being conducted in Montreal, Quebec, Canada, 100 men and 100 women with type 2 diabetes will undergo four assessments (once per season) over a one-year period of observation. These assessments include (1) use of a pedometer with a concealed viewing window for a two-week period to measure walking (2) a study centre visit during which venous blood is sampled for A1C, anthropometrics are assessed, and questionnaires are completed for measurement of other factors that may influence walking and/or A1C (e.g. food frequency, depressive symptomology, medications). The relationship between spring-fall A1C difference and winter-summer difference in steps/day will be examined through multivariate linear regression models adjusted for possible confounding. Interpretation of findings by researchers in conjunction with potential knowledge "users" (e.g. health professionals, patient groups) will guide knowledge translation efforts. DISCUSSION: Although we cannot alter weather patterns to favour active lifestyles, we can design treatment strategies that take seasonal and weather-related variations into account. For example, demonstration of seasonal variation of A1C levels among Canadian men and women with T2D and greater understanding of its determinants could lead to (1) targeting physical activity levels to remain at or exceed peak values achieved during more favourable weather conditions. Strategies may include shifting to indoor activities or adapting to less favourable conditions (e.g. appropriate outdoor garments, more frequent but shorter duration periods of activity) (2) increasing dose/number of glucose-lowering medications during the winter and reducing these during the summer, in anticipation of seasonal variations (3) examining the impact of bright light therapy on activity and A1C among T2D patients with an increase in depressive symptomology when sunlight hours decline.


Research Support, Non-U.S. Gov't

PMID: 17224062


24: Psychiatry Res. 2007 Jan 15;149(1-3):315-20. Epub 2006 Dec 11.


A pilot study of adherence with light treatment for seasonal affective disorder.

Michalak EE, Murray G, Wilkinson C, Dowrick C, Lam RW.

Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall

Vancouver, BC, Canada V6T 2A1. emichala@interchange.ubc.ca

Non-adherence with antidepressant medication regimens is now recognised as a substantial problem when evaluating depression outcome. Given the behavioural demands of light treatment (LT), it might be expected that non-adherence would be even more pronounced in LT, a form of intervention for seasonal affective disorder (SAD). However, little research has focused upon the extent to which patients in light treatment protocols adhere to set regimens. Nineteen patients with SAD were allocated to either treatment with bright white light (intervention) or dim red light (control condition) in a four-week protocol. Light exposure was estimated automatically (without participants' knowledge) with elapsed time meters built into the light box. Daily diaries were also used to measure self-reported light box use. Participants were instructed to use the light box for 30 min each day during week 1, 45 during week 2 and one hour during weeks 3 and 4 (total duration of prescribed light exposure 1365 min). The results indicated that mean duration of light box operation for the entire sample was 59.3% of the prescribed 1365 min. Six of nineteen (31.6%) patients dropped out of treatment. Amongst those completing treatment, adherence to the prescribed duration of exposure averaged 83.3% (S.D.=31.4). A trend was found for the intervention condition to generate a lower dropout rate, as well as a trend for the degree of adherence to be greater in the intervention condition. Importantly, there was no association between adherence as measured automatically and the higher rates of self-reported adherence as measured in diaries. In summary, the results of this pilot study suggest that adherence with light treatment is of a similar order of magnitude to antidepressant medication adherence. Patient self-report was found to be unrelated to objectively estimated duration of light box use, a finding with significant research and clinical implications. Future research studies should routinely measure and evaluate adherence with light therapy and evidence-based techniques for maximising treatment adherence should be incorporated into routine clinical practice.


Research Support, Non-U.S. Gov't

PMID: 17161464


25: Arch Womens Ment Health. 2007;10(5):221-4. Epub 2007 Aug 16.


Morning light therapy for postpartum depression.

Corral M, Wardrop AA, Zhang H, Grewal AK, Patton S.

Reproductive Mental Health Program, St. Paul's Hospital, Vancouver, B.C., Canada.

mcorral@providencehealth.bc.ca

Postpartum depression (PPD) is a frequent complication of childbirth, but many women refuse pharmacological treatment. Little data exists on bright light therapy for PPD. Fifteen outpatient women with PPD were randomly assigned to bright light (10,000 lux, n = 10) or dim red light (600 lux, n = 5) and completed a 6-week trial and weekly assessments using self-report depression scales and clinician ratings of symptom course. Both groups showed significant improvement over time on all measures, with no significant difference between conditions.


Randomized Controlled Trial

Research Support, Non-U.S. Gov't

PMID: 17701271


26: Behav Sleep Med. 2007;5(1):57-76.


Clinical management of delayed sleep phase disorder.

Lack LC, Wright HR.

School of Psychology, Flinders University, South Australia. leon.lack@flinders.edu.au

Delayed Sleep Phase Disorder is a circadian rhythm disorder that results in a late timed sleep pattern. Individuals have difficulty falling asleep at a conventional hour and difficulty waking in the morning. We discuss the contributing factors and consequences of a delayed sleep phase and describe treatment approaches. These include therapies to phase change the delayed sleep circadian rhythm such as morning bright light exposure, exogenous melatonin administration, and chronotherapy as well as some behavioral strategies.


Review

PMID: 17313324


27: Chronobiol Int. 2007;24(3):521-37.


Primary and secondary features of Parkinson's disease improve with strategic exposure to bright light: a case series study.

Willis GL, Turner EJ.

The Bronowski Institute of Behavioural Neuroscience, Coliban Medical Centre,

Kyneton, Victoria, Australia. gwillbro@nex.net.au

The antagonism of melatonin in models of Parkinson's disease (PD) can reduce the severity of motor impairment associated with dopamine (DA) degeneration. In consideration of the potent antidepressant effects of bright light therapy (LT), that LT suppresses melatonin secretion, that depression is commonly observed in PD, and that exposure to constant light facilitates recovery from experimental PD, the object of the present study was to strategically administer LT to PD patients and observe the effects on depression, insomnia, and motor performance. Twelve patients diagnosed with PD were exposed to white fluorescent light for 1-1.5 h at an intensity of 1000 to 1500 lux once daily commencing 1 h prior to the usual time of sleep onset, approximately 22:00 h in most patients. All patients were assessed before LT commenced and at two weeks, five weeks, and regular intervals thereafter. Within two weeks after commencing LT, marked improvement in bradykinaesia and rigidity was observed in most patients. Tremor was not affected by LT treatment; however, agitation, dyskinaesia, and psychiatric side effects were reduced, as verified by decreased requirement for DA replacement therapy. Elevated mood, improved sleep, decreased seborrhea, reduced impotence, and increased appetite were observed after LT. LT permitted the reduction of the dose of L-dopa, bromocriptine, or deprenyl in some patients by up to 50% without loss of symptom control. Factors limiting the efficacy of LT included multiple disease states, treatment compliance, polypharmacy, emotional stress, advanced age, and predominance of positive symptoms. The results of this case series study confirms previous work describing light as efficacious in the treatment of PD and suggest that controlled trials may help to elucidate how LT might be used strategically as an adjunct therapy to improve the morbidity of PD patients.


Clinical Trial

Research Support, Non-U.S. Gov't

PMID: 17612949


28: CNS Drugs. 2007;21(11):901-9.


Long-term and preventative treatment for seasonal affective disorder.

Westrin A, Lam RW.

Department of Clinical Sciences, Division of Psychiatry, Lund University Hospital, Lund, Sweden.

Recurrent major depressive disorder with regular seasonal patterns, commonly known as seasonal affective disorder (SAD), has evoked substantial research in the last two decades. It is now recognised that SAD is a common condition with prevalence rates between 0.4% and 2.9% of the general population, and that patients with SAD experience significant morbidity and impairment in psychosocial function.There is good evidence that bright light therapy and antidepressant medications are effective for the short-term treatment of SAD; however, given that SAD is characterised by recurrent major depressive episodes, long-term and maintenance treatment must be considered. Unfortunately, there are few studies of longer term (>8 weeks) and maintenance (preventative) treatments for SAD. The weight of evidence suggests that light therapy usually needs to be continued daily throughout the winter season because of rapid relapse when light is stopped too early in the treatment period. However, some studies support the use of antidepressants to continue the response from a brief (1-2 weeks) course of light therapy early in the depressive episode, as soon as the first symptoms emerge in autumn. Only small studies have examined preventative treatment (before onset of symptoms) with light therapy, all of which have methodological limitations. The best evidence for preventative treatment in SAD comes from antidepressant studies. Three large, randomised, placebo-controlled studies have shown that preventative treatment with bupropion XL reduces the recurrence rate of depressive episodes in patients with SAD.Given the limitations in the evidence base and the inconsistent recurrence rate of winter depressive episodes, clinical recommendations for long-term and preventative treatment must individualise treatment choices and weigh potential benefits against possible adverse effects.
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