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

Controlled Clinical Trial

PMID: 16102546


54: Acta Psychiatr Scand. 2005 Aug;112(2):117-25.


Adjunctive bright light in non-seasonal major depression: results from clinician-rated depression scales.

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

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

kmar@fa.dk

OBJECTIVE: To investigate the use of bright light therapy as an adjunct treatment to sertraline in non-seasonal major depression. METHOD: In a randomised double-blind trial, 102 patients were treated for 5 weeks with either white bright light (10 000 lux, 1 h daily) or red dim light (50 lux, 30 min daily). All patients were treated with sertraline in a fixed dose of 50 mg daily. The clinician-rated depression scales used were the Hamilton Depression Rating Scale (HAM-D17), Hamilton six-item subscale (HAM-D6), Melancholia Scale (MES) and the seven 'atypical' items from the SIGH-SAD. RESULTS: One-hundred and two patients were included in the study. Analyses showed that the reduction in depression scores in the bright light group was statistically significantly larger than in the dim light group on all scales. The scale most sensitive at endpoint was the HAM-D(6), which includes the core symptoms of depression. CONCLUSION: The study results support the use of bright light as an adjunct treatment to antidepressants in non-seasonal depression. Copyright 2005 Blackwell Munksgaard.


Clinical Trial

Randomized Controlled Trial

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

PMID: 15992393


55: CNS Spectr. 2005 Aug;10(8):664-9; quiz 672.


Pharmacotherapy of seasonal affective disorder.

Pjrek E, Winkler D, Kasper S.

Department of General Psychiatry at the Medical University of Vienna, Vienna,

Austria. edda.pjrek@meduniwien.ac.at

Seasonal affective disorder is a common variant of recurrent major depressive disorder or bipolar disorder. Treatment with bright artificial light has been found to be effective in this condition. However, for patients who do not respond to light therapy or those who lack compliance, conventional drug treatment with antidepressants also has been proposed. Substances with selective serotonergic or noradrenergic mechanisms should be preferred over older antidepressants. Although there are a number of open and controlled studies evaluating different compounds, these studies were often limited by relatively small sample sizes. Furthermore, there are no studies specifically addressing bipolar seasonal depression. This article will review the published literature on pharmacotherapy of seasonal affective disorder.


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

Review

PMID: 16041297


56: CNS Spectr. 2005 Aug;10(8):647-63; quiz 672.


Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects.

Terman M, Terman JS.

Clinical Chronobiology, New York State Psychiatric Institute, New York, NY 10032,

USA. mt12@columbia.edu

Bright light therapy for seasonal affective disorder (SAD) has been investigated and applied for over 20 years. Physicians and clinicians are increasingly confident that bright light therapy is a potent, specifically active, nonpharmaceutical treatment modality. Indeed, the domain of light treatment is moving beyond SAD, to nonseasonal depression (unipolar and bipolar), seasonal flare-ups of bulimia nervosa, circadian sleep phase disorders, and more. Light therapy is simple to deliver to outpatients and inpatients alike, although the optimum dosing of light and treatment time of day requires individual adjustment. The side-effect profile is favorable in comparison with medications, although the clinician must remain vigilant about emergent hypomania and autonomic hyperactivation, especially during the first few days of treatment. Importantly, light therapy provides a compatible adjunct to antidepressant medication, which can result in accelerated improvement and fewer residual symptoms.


Research Support, N.I.H., Extramural

Research Support, U.S. Gov't, P.H.S.

Review

PMID: 16041296


57: CNS Spectr. 2005 Aug;10(8):625-34; quiz 1-14.


The diagnosis, symptomatology, and epidemiology of seasonal affective disorder.

Magnusson A, Partonen T.

Department of Psychiatry, Aker University Hospital, Oslo, Norway. andres.magnusson@medisin.uio.no

The 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.


Review

PMID: 16041294


58: Int J Geriatr Psychiatry. 2005 Aug;20(8):738-43.


Effect of timed bright light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease.

Dowling GA, Mastick J, Hubbard EM, Luxenberg JS, Burr RL.

University of California, San Francisco, CA 94143-0610, USA. glenna.dowling@nursing.ucsf.edu

BACKGROUND: Disturbances in rest-activity rhythm are prominent and disabling symptoms in Alzheimer's disease (AD). Nighttime sleep is severely fragmented and daytime activity is disrupted by multiple napping episodes. In most institutional environments, light levels are very low and may not be sufficient to entrain the circadian clock to the 24-hour day. METHOD: The purpose of this randomized clinical trial was to test the effectiveness of timed bright light therapy in reducing rest-activity (circadian) disruption in institutionalized patients with AD. The experimental groups received either morning (9.30-10.30 am) or afternoon (3.30-4.30 pm) bright light exposure ( > or = 2500 lux in gaze direction) Monday through Friday for 10 weeks. The control group received usual indoor light (150-200 lux). Nighttime sleep, daytime wake, and rest-activity parameters were determined by actigraphy. Repeated measures analysis of variance was employed to test the primary study hypotheses. RESULTS: Seventy institutionalized subjects with AD (mean age 84) completed the study. No significant differences in actigraphy-based measures of nighttime sleep or daytime wake were found between groups. Subjects in either experimental light condition evidenced a significantly (p < 0.01) more stable rest-activity rhythm acrophase over the 10-week treatment period compared to the control subjects whose rhythm phase delayed by over two hours. CONCLUSIONS: One hour of bright light, administered to subjects with AD either in the morning or afternoon, did not improve nighttime sleep or daytime wake compared to a control group of similar subjects. However, exposure to one-hour of bright light in either the morning or afternoon may provide sufficient additional input to the circadian pacemaker to facilitate entrainment to the 24-hour day. © 2005 John Wiley & Sons, Ltd.


Multicenter Study

Randomized Controlled Trial

Research Support, N.I.H., Extramural

Research Support, U.S. Gov't, P.H.S.

PMID: 16035127

59: Dermatol Ther. 2005 Jul-Aug;18(4):323-7.


Itch in systemic disease: therapeutic options.

Greaves MW.

National Skin Centre, Singapore. mwatsong@hotmail.com

A new pathophysiologically based classification of itch is proposed, which should help the clinician adopt a rational approach to diagnosis and management of generalized itch. Focusing on neurogenic itch (itch without visible rash), common causes are reviewed and guidelines for laboratory and radiologic investigation are proposed. A stepwise approach to the management of generalized itch resulting from systemic disease is recommended. Specifically, the relative merits of broad versus narrowband ultraviolet B (UVB) are discussed and the pros and cons of doxepin, opioid antagonists, and selective serotonin reuptake inhibitors (SSRIs) such as paroxetine are considered. Attention is drawn to some novel approaches, including bright-light phototherapy and molecular adsorbent recirculating system (MARS) for selected patients with intractable itch caused by hepatic failure, and mirtazapine for nocturnal itch.


Review

PMID: 16297004


60: Psychol Med. 2005 Jul;35(7):945-55.


Controlled trial of bright light and negative air ions for chronic depression.

Goel N, Terman M, Terman JS, Macchi MM, Stewart JW.

Department of Psychology, 207 High Street, Judd Hall, Wesleyan University,

Middletown, CT 06459, USA. ngoel@wesleyan.edu

BACKGROUND: This randomized controlled trial investigates the efficacy of two non-pharmacologic treatments, bright light and high-density negative air ions for non-seasonal chronic depression. Both methods have shown clinical success for seasonal affective disorder (SAD). METHOD: Patients were 24 (75%) women and 8 (25%) men, ages 22-65 years (mean age +/- S.D., 43.7 +/- 12.4 years), with Major Depressive Disorder, Single Episode (DSM-IV code, 296.2), Chronic (episode duration > or = 2 years). Patients were entered throughout the year and randomly assigned to exposure to bright light (10 000 lux, n = 10), or high-density (4.5 x 10(14) ions/s flow rate, n = 12) or low-density (1.7 x 10(11) ions/s, n = 10, placebo control) negative air ions. Home treatment sessions occurred for 1 h upon awakening for 5 weeks. Blinded raters assessed symptom severity weekly with the Structured Interview Guide for the Hamilton Depression Rating Scale—Seasonal Affective Disorder (SIGH-SAD) version. Evening saliva samples were obtained before and after treatment for ascertainment of circadian melatonin rhythm phase. RESULTS: SIGH-SAD score improvement was 53.7% for bright light and 51.1% for high-density ions v. 17.0% for low-density ions. Remission rates were 50%, 50% and 0% respectively. The presence or severity of atypical symptoms did not predict response to either treatment modality, nor were phase advances to light associated with positive response. CONCLUSIONS: Both bright light and negative air ions are effective for treatment of chronic depression. Remission rates are similar to those for SAD, but without a seasonal dependency or apparent mediation by circadian rhythm phase shifts. Combination treatment with antidepressant drugs may further enhance clinical response.


Clinical Trial

Randomized Controlled Trial

Research Support, N.I.H., Extramural

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

Research Support, U.S. Gov't, P.H.S.

PMID: 16045061

61: Tidsskr Nor Laegeforen. 2005 Jun 16;125(12):1679-81.


[Bright light treatment against sleep disturbances in nursing homes—a non-pharmacological

alternative]

[Article in Norwegian]

Fetveit A, Bjorvatn B.

Institutt for allmenn- og samfunnsmedisin, Universitetet i Oslo, Postboks 1130

Blindern, 0318 Oslo. arne.fetveit@medisin.uio.no

BACKGROUND: Age-related sleep disturbances may be caused by changes in the circadian rhythm, either by phase shifting and/or by a reduction of its amplitude. This may result in less nocturnal sleep and less wakefulness during the day. MATERIAL AND METHODS: The article is based on our own research and on relevant studies and reviews in this field. RESULTS AND INTERPRETATION: Bright light treatment may alter the phase and strengthen the existing circadian rhythm in patients with insomnia, thus creating a clearer distinction between night and day. It is reported that bright light treatment in the morning for patients with dementia may improve sleep maintenance.


English Abstract

PMID: 15976841


62: Acta Psychiatr Scand. 2005 Jun;111(6):453-9.


Adjunctive bright light in non-seasonal major depression: results from patient-reported symptom and well-being scales.

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

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

kmar@fa.dk

OBJECTIVE: In this study, we tested the efficacy of bright light therapy as an adjunct to antidepressant treatment (sertraline) in patients with non-seasonal major depression. METHOD: In a randomized double-blind controlled trial, 102 patients were treated for 5 weeks with either white bright light (10.000 lx, 1 h/day) or red dim light (50 lx, 30 min/day). All patients received sertraline in a dosage of 50 mg daily. The self-assessment scales used were the Major Depression Inventory (MDI), the Psychological General Well-Being Scale (PGWB) and the Symptom Check List (SCL-90R). RESULTS: On all three questionnaires the score differences between baseline and endpoint were greatest in the bright light group. On the SCL-90R, the difference reached statistical significance. Results and effect sizes are compared with results from Danish national population studies applying PGWB and SCL-90R. CONCLUSION: The results advocate the use of bright light as an adjunct treatment of non-seasonal depression.


Clinical Trial

Randomized Controlled Trial

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

PMID: 15877712


63: Int Psychogeriatr. 2005 Jun;17(2):221-36.


Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease.

Dowling GA, Hubbard EM, Mastick J, Luxenberg JS, Burr RL, Van Someren EJ.

University of California, San Francisco, Department of Physiological Nursing, 2

Koret Way, Room N631, San Francisco, CA 94143-0610, USA. glenna.dowling@nursing.ucsf.edu

BACKGROUND: Disturbances in rest-activity rhythm are prominent and disabling

symptoms in Alzheimer's disease (AD). Nighttime sleep is severely fragmented and

daytime activity is disrupted by multiple napping episodes. In most

institutional environments, light levels are very low and may not be sufficient

to enable the circadian clock to entrain to the 24-hour day. The purpose of this

randomized, placebo-controlled, clinical trial was to test the effectiveness of

morning bright light therapy in reducing rest-activity (circadian) disruption in

institutionalized patients with severe AD. METHOD: Subjects (n = 46, mean age 84

years) meeting the NINCDS-ADRDA (National Institute of Neurological and

Communicative Disorders and Stroke—the Alzheimer's Disease and Related

Disorders Association) AD diagnostic criteria were recruited from two large,

skilled nursing facilities in San Francisco, California. The experimental group
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