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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Clinical Trial

Comparative Study

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

PMID: 17107243


36: Acta Psychiatr Scand. 2006 Sep;114(3):216-8; discussion 218-9.


Bright light therapy for seasonal affective disorder in Israel (latitude 32.6 degrees N): a single case placebo-controlled study.

Moscovici L.

Department of Psychiatry, Tel Aviv Sourasky Medical Center, Sackler Faculty of

Medicine, Tel Aviv University, Tel Aviv, Israel. lozian@netvision.net.il

INTRODUCTION: We describe a patient diagnosed as having seasonal affective disorder (SAD, winter depression), an unlikely condition in Israel (latitude 32.6 degrees N), a country with relatively minor daylight photoperiodic changes between seasons. METHOD: Case report. RESULTS: A 46-year-old woman with a clinical picture of depression (Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria for 'major depression with seasonal pattern') reacted positively to 3 weeks of daily bright light therapy of 10,000 lux/wide spectrum. She was asked to wear dark sunglasses during placebo sessions to accommodate an A-B-C single-case-design. The intervention resulted in an improvement of 74-80% in the Hamilton anxiety and depression scales (clinician-rated) and the Beck depression inventory, similar to results obtained in high latitude regions. The depression and anxiety levels returned close to baseline levels following 1 week of the placebo intervention. CONCLUSION: Seasonal affective disorder is apparently not limited to certain latitudes. The effect of light therapy was short-lived after discontinuation of the treatment, with rapid relapse occurring in the placebo phase.


Case Reports

Controlled Clinical Trial

PMID: 16889593


37: Psychol Med. 2006 Sep;36(9):1247-52. Epub 2006 Jun 7.


Erratum in:

Psychol Med. 2006 Sep;36(9):1336.

Comment in:

Evid Based Ment Health. 2007 May;10(2):49.

The lack of sustained effect of bright light, after discontinuation, in non-seasonal major depression.

Martiny K, Lunde M, Undén M, Dam H, Bech P.

Psychiatric Research Unit, Frederiksborg General Hospital, Hilleroed, Denmark.

kmar@fa.dk

BACKGROUND: Recently accumulated evidence has demonstrated that bright-light therapy in combination with antidepressants is effective in patients with non-seasonal major depression. Whether bright light has a sustained effect after discontinuation is, however, poorly investigated. METHOD: In this double-blind randomized study we report the results from a 4-week follow-up period in patients with major non-seasonal depression who had been treated for 5 weeks with sertraline combined with bright-light therapy or sertraline combined with dim-light therapy. At the beginning of the follow-up period the light therapy was stopped while sertraline treatment continued for 4 weeks. RESULTS:

Depression scores decreased substantially in both groups, resulting in high response and remission rates in both groups after 9 weeks of treatment. The difference in depression scores at week 5, favouring the bright-light-treated group, disappeared gradually in the 4-week follow-up period, resulting in similar end-point scores. CONCLUSIONS: Bright light did not have a sustained effect after discontinuation. The offset of effect was complete after 4 weeks.


Randomized Controlled Trial

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

PMID: 16756691


38: Psychol Med. 2006 Sep;36(9):1253-63. Epub 2006 Jun 7.


Bright light, negative air ions and auditory stimuli produce rapid mood changes in a student population: a placebo-controlled study.

Goel N, Etwaroo GR.

Department of Psychology, Wesleyan University, Middletown, CT 06459, USA. ngoel@wesleyan.edu

BACKGROUND: Bright light and high-density negative air ion exposure are efficacious for winter and non-seasonal depression compared with a low-density negative ion placebo. Similarly, auditory stimuli improve mood in clinical populations. This study compared the short-term effects of bright light, an auditory stimulus, and high- and low-density negative ions on mood and alertness in mildly depressed and non-depressed adults. METHOD: One hundred and eighteen subjects, 69 women and 49 men (mean age+/-S.D., 19.4+/-1.7 years), participated once across the year. Subjects were randomly assigned to one of four conditions: bright light (10,000 lux; n=29), auditory stimuli (60 dB; n=30), or high-density (4.5x10(14) ions/s flow rate; n=29) or low-density (1.7x10(11) ions/s; n=30; placebo control) negative ions. Exposure was for 30 min on three consecutive evenings between 1900 and 2100 hours. Mood and alertness assessments, using standardized scales, occurred before, and 15 and 30 min during exposure. The Beck Depression Inventory classified subjects as depressed (> or =10; n=35) or non-depressed (<10; n=83). RESULTS: The three active stimuli, but not the low-density placebo, reduced depression, total mood disturbance (a global affect measure) and/or anger within 15-30 min. Neither testing season nor degree of depressive symptoms affected response to stimuli. CONCLUSIONS: The auditory stimulus, bright light and high-density ions all produced rapid mood changes - with small to medium effect sizes - in depressed and non-depressed subjects, compared with the low-density placebo, despite equivalent pre-study expectations. Thus, these stimuli improve mood acutely in a student sample, including a subset with depressive symptoms.


Randomized Controlled Trial

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

PMID: 16756690


39: Expert Rev Neurother. 2006 Jul;6(7):1039-48.


Treatment of seasonal affective disorder.

Winkler D, Pjrek E, Iwaki R, Kasper S.

Medical University of Vienna, Department of General Psychiatry Währinger Gürtel

18-20 A-1090 Vienna, Austria. dietmar.winkler@meduniwien.ac.at

Seasonal affective disorder (SAD), winter type, is characterized by the regular annual onset of major depressive episodes during fall or winter, followed by spontaneous remission and sometimes hypomanic or manic episodes during spring and summer. SAD is clinically important, since approximately 2-5% of the general population in temperate climates are affected. Since the first description of the syndrome, researchers have made attempts to elucidate the pathophysiological background of SAD. Bright light therapy has been proposed as the treatment of choice for this disorder. However, numerous studies have also investigated suitable psychopharmacological treatments for SAD. This report is aimed to provide an overview on the clinical management and current therapeutic options for SAD.


Review

PMID: 16831117


40: J Affect Disord. 2006 Apr;91(2-3):251-5. Epub 2006 Feb 2.


Seasonality of mood disorders in adults with lifetime attention-deficit/hyperactivity disorder (ADHD).

Amons PJ, Kooij JJ, Haffmans PM, Hoffman TO, Hoencamp E.

Parnassia Group, PsyQ, psycho-medical programmes, Programme Adult ADHD, Carel Reinierszkade 197, 2593 HR Den Haag, The Netherlands.

BACKGROUND: The objective of this study was to estimate the prevalence of Seasonal Affective Disorder (SAD) in adults with lifetime Attention-Deficit/Hyperactivity Disorder (ADHD). METHOD: Patients eligible for this study had lifetime impairing symptoms of ADHD and a current and/or past co-morbid mood disorder according to their medical record. The Seasonal Pattern Assessment Questionnaire (SPAQ) was administered by a telephone interview to assess seasonality. RESULTS: The overall rate of SAD in this clinical population of adults with ADHD was estimated at 27%. Females were more at risk to develop SAD than men. LIMITATIONS:

The SPAQ is a screening, not a diagnostic instrument. CONCLUSIONS: SAD symptoms are frequently comorbid with ADHD in adults. These results have clinical relevance for the recognition and treatment of SAD with bright light therapy in adults with ADHD.

PMID: 16458365

41: Sleep. 2006 Apr 1;29(4):462-9.


Indoor exposure to natural bright light prevents afternoon sleepiness.

Kaida K, Takahashi M, Haratani T, Otsuka Y, Fukasawa K, Nakata A.

National Institute of Industrial Health, Kawasaki, Japan. kaidak@niih.go.jp

STUDY OBJECTIVES: The present study examined the effects of indoor exposure to natural bright light on afternoon sleepiness. DESIGN: Participants took part in 3 experimental conditions: (1) a natural bright light condition in which they carried out performance and arousal tests sitting near a window (3260.0 +/- 1812.43 lux) from 12:40 PM to 1:10 PM, (2) a nap condition in which they were provided a nap opportunity for 20 minutes from 12:45 PM, and (3) a control condition in which they performed the tests in less than 100 lux surroundings from 12:40 PM to 1:10 PM. Before and after each treatment, the same series of tests were administered. SETTING: A temperature- and light-controlled sleep laboratory. PARTICIPANTS: Sixteen healthy female paid volunteers aged 33 to 43 (38.1 +/- 2.68) years. INTERVENTIONS: Indoor natural bright light and a short nap. MEASUREMENTS AND RESULTS: Arousal levels were measured by the Psychomotor Vigilance Task, Alpha Attenuation Test, Karolinska Drowsiness Test, and Karolinska Sleepiness Scale. The tests were repeated every 30 minutes from 11:00 AM to 4:10 PM. Ambient light intensity was maintained at less than 100 lux, except during natural bright light exposure. Short-term exposure to natural bright light significantly improved afternoon arousal levels, as measured by the Karolinska Drowsiness Test and Alpha Attenuation Test, the effects of which continued for at least 60 minutes (1:10-2:10 PM). However, no significant differences were observed between conditions for Psychomotor Vigilance Test performance. CONCLUSIONS: Brief indoor exposure to natural bright light may decrease afternoon sleepiness. This technique of light could be used in work settings in which napping is not permitted.

PMID: 16676779

42: Psychiatr Pol. 2006 Mar-Apr;40(2):261-7.


[Bright light therapy in pregnant women depression--3 case studies]

[Article in Polish]

Krzystanek M, Krupka-Matuszczyk I.

Katedra i Klinika Psychiatrii i Psychoterapii, Slaskiej AM w Katowicach.

AIM: Bright light therapy (BLT) is a new method of biological treatment in psychiatry. Good tolerance makes it an attractive method used not only in seasonal affective disorder. An episode of depression during pregnancy may be a new indication. The study aimed to describe effects of treatment of depression in 3 pregnant women. METHOD: The women were out-patients in their 6-th, 7-th and 8-th months of pregnancy and diagnosed with depression according to ICD-10 criteria. The treatment was a morning exposure to 1 hour 5 000 LUX bright light from Monday to Friday. The antidepressant effect was assessed after the 2nd and 4th week of BLT. Side effects of BLT were monitored over the whole BLT treatment period. RESULTS: The mean improvement of depressive symptoms after 2 and 4 weeks of BLT was 33% and 55%, respectively. Side effects were not observed in any of the patients. CONCLUSIONS: Morning BLT seems to be an effective and a very well tolerated mode of treatment of pregnant women suffering from non-seasonal depression. The manner and length of BLT maintenance treatment requires further studies.


Case Reports

English Abstract

PMID: 17037101


43: Curr Pharm Des. 2006;12(4):503-15.


Recent progress in pharmacological and non-pharmacological treatment options of major depression.

Baghai TC, Möller HJ, Rupprecht R.

Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of

Munich, Nussbaumstrasse 7, D-80336 Munich, Germany. Baghai@med.uni-muenchen.de

In spite of recent progress in the pharmacotherapy of depression major issues are still unresolved. These include the non-response rate of approximately 30% to conventional antidepressant pharmacotherapy, side effects of available antidepressants and the latency of several weeks until clinical improvement. The only non-pharmacological biological treatment options available so far which exert more rapid antidepressant efficacy are electroconvulsive therapy and, as an augmentation strategy, sleep deprivation. Current pharmacological treatments aim to enhance serotonergic and/or noradrenergic neurotransmission. In spite of emerging knowledge, the crucial mechanisms underlying both non-pharmacological treatments, which are responsible for antidepressant efficacy, are not yet clear so far. In the meantime several new pharmacological principles are under investigation with regard to their putative antidepressant potency. These include 5-HT1A receptor agonists, tachykinin receptor antagonists and various interventions within the hypothalamic-pituitary-adrenal system. While there is evidence for antidepressant properties of these new treatments in animal studies, in case series, in open studies and to some degree also in placebo controlled studies, no definite proof for the antidepressant efficacy of these new pharmacological strategies according to the requirements for evaluation of antidepressant drugs has been furnished so far. In contrast, for the established non-pharmacological treatment strategies including bright light therapy the clinical efficacy has been proven at least in subgroups of depression, but more knowledge of the main mechanisms underlying their antidepressant efficacy is still necessary. In addition new non-pharmacological treatments like repetitive transcranial magnetic stimulation, magnetic seizure therapy and Vagus nerve stimulation are currently under development. Nevertheless, a follow-up of both the new pharmacological strategies and non-pharmacological treatment options is of major importance to provide even better strategies for the clinical management of depression, which also is of great socio-economic impact.


Review

PMID: 16472142


44: World J Biol Psychiatry. 2006;7(3):138-51.


Melatonin in mood disorders.

Srinivasan V, Smits M, Spence W, Lowe AD, Kayumov L, Pandi-Perumal SR, Parry B, Cardinali DP.

Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan.

The cyclic nature of depressive illness, the diurnal variations in its symptomatology and the existence of disturbed sleep-wake and core body temperature rhythms, all suggest that dysfunction of the circadian time keeping system may underlie the pathophysiology of depression. As a rhythm-regulating factor, the study of melatonin in various depressive illnesses has gained attention. Melatonin can be both a 'state marker' and a 'trait marker' of mood disorders. Measurement of melatonin either in saliva or plasma, or of its main metabolite 6-sulfatoxymelatonin in urine, have documented significant alterations in melatonin secretion in depressive patients during the acute phase of illness. Not only the levels but also the timing of melatonin secretion is altered in bipolar affective disorder and in patients with seasonal affective disorder (SAD). A phase delay of melatonin secretion takes place in SAD, as well as changes in the onset, duration and offset of melatonin secretion. Bright light treatment, that suppresses melatonin production, is effective in treating bipolar affective disorder and SAD, winter type. This review discusses the role of melatonin in the pathophysiology of bipolar disorder and SAD.


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

Review

PMID: 16861139


45: Percept Mot Skills. 2005 Dec;101(3):759-70.
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