A randomized controlled trial of cognitive-behavioral therapy, light therapy, and their combination for seasonal affective disorder.

Abstract

This first controlled psychotherapy trial for seasonal affective disorder (SAD) compared SAD-tailored cognitive-behavioral therapy (CBT), light therapy (LT), and their combination to a concurrent wait-list control. Adults (N = 61) with major depression, recurrent with seasonal pattern, were randomized to one of four 6-week conditions: CBT (1.5-hr twice-weekly group therapy), LT (10,000-lux for 90-min/day with administration time individually adjusted), combined CBT + LT, or a minimal contact/delayed LT control (MCDT; LT following 6 weeks of monitoring). CBT, LT, and CBT + LT significantly and comparably improved depression severity relative to MCDT in intent-to-treat and completer samples. CBT + LT (73%) had a significantly higher remission rate than MCDT (20%). Using prospectively measured summer mood status to estimate the "functional" population, CBT + LT also had a significantly larger proportion of participants with clinically significant change over treatment compared with MCDT. The LT condition outcomes virtually replicated results from prior trials. CBT, alone or combined with LT, holds promise as an efficacious SAD treatment and warrants further study. If replicated, CBT + LT's remission rate would represent a clinically meaningful improvement over the 53% observed across LT studies.

Differential predictions about future negative events in seasonal and non-seasonal depression

“…Mean SIGH-SAD scores for the SD group are comparable with other studies (Rohan et al 2007), attesting to the representativeness of the SD sample.…”

“…It is important to continue to build an understanding of how negative information about the self and the world is processed in SD in the context of the rapid development of cognitive-behavioural interventions for the condition that draw upon knowledge of the cognitive profile associated with the syndrome (Rohan et al 2007). The present data, allied to the previous findings on memory biases (Dalgleish et al , 2004, suggest that the self-referential nature of cognitive processing may be an important theme in this endeavour.…”

Rumination and Vegetative Symptoms: A Test of the Dual Vulnerability Model of Seasonal Depression

“…Our findings suggest that treatments for SAD and subclinical seasonality might effectively target psychological vulnerabilities, such as ruminative response style, to ameliorate the impact of seasonal changes in vegetative symptoms. Results of a study of cognitive behavior therapy tailored to SAD (Rohan et al 2007) indicate that this may be the case.…”

Pathogenesis and management of seasonal affective disorder

“…Of most relevance would be cognitive behavioural therapy (CBT) for which there is a large evidence base for its use in other mood disorders. Preliminar y data by Rohan et al 50,51 suggest that a tailored course of CBT is as efficacious as light therapy in the acute phase and better at preventing relapse; 52 however, there is a clear need for further study.…”