A sham-controlled randomized trial of adjunctive light therapy for non-seasonal depression

Chojnacka, Magdalena; Antosik-Wójcińska, Anna; Bzinkowska, Dorota; Borzym, Agnieszka; Sokół-Szawłowska, Marlena; Bodzak-Opolska, Gabriela; Antoniak, Dorota; Święcicki, Łukasz

doi:10.1016/j.jad.2016.05.062

Cited by 24 publications

(20 citation statements)

References 41 publications

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“…27 Three studies examined medication use retrospectively and found no differences between conditions. 25,28,31 In the sensitivity analysis of potential sources of variability in study methodology, excluding the study with 11 participants with bipolar SAD changed the results from positive to narrowly missing statistical significance. In addition, the sensitivity analysis that excluded the quasi-randomized trial found no difference between active light and control conditions, although that analysis included only five fully randomized trials (198 participants).…”

Section: Discussionmentioning

confidence: 99%

“…26 The duration of follow-up ranged from 14 days for four studies to 28, 42, and 56 days for each of three studies. The control conditions also varied: two studies used an inactive negative ion generator, 28,29 one study used a low-density negative ion generator, 30 and four studies used low intensity light (100 lux or less in three studies, and 500 lux or less in one study). Note that one study 29 examined 400 lux narrow-spectrum (green) light as an active treatment compared to a nonlight control condition, although 400 lux would generally be considered no brighter than illumination in a typical office setting.…”

Section: Figure 1 Shows the Preferred Reporting Items For Systematicmentioning

confidence: 99%

“…Depressive symptom scores at endpoint were available for all seven trials (259 participants), and all used a version of the HAM-D. Two of the studies 28,29 included both unipolar and bipolar participants, but the investigators provided separate data for the BD participants. The Rosenthal et al study 26 was the only one with a crossover study design; only data from the first arm of the crossover were used in the analysis.…”

Section: Meta-analyses: Primary Outcomesmentioning

confidence: 99%

“…The rates of treatment-emergent mania or hypomania were available for all seven trials (Figure S6). Note that six studies [25][26][27][28][29]31 did not observe any switches in either active light or control conditions, so the 0.5 event imputation rule was applied to both conditions. Active light treatment was not associated with an increased risk of affective switches compared to control conditions (OR ¼ 1.30; 95% CI, 0.38 to 4.44; P ¼ 0.67).…”

Section: Study Discontinuationmentioning

confidence: 99%

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Light Therapy for Patients With Bipolar Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2019

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Objective Bipolar disorder (BD) is challenging to treat, and fewer treatments are available for depressive episodes compared to mania. Light therapy is an evidence-based nonpharmacological treatment for seasonal and nonseasonal major depression, but fewer studies have examined its efficacy for patients with BD. Hence, we reviewed the evidence for adjunctive light therapy as a treatment for bipolar depression. Methods We conducted a systematic review of databases from inception to June 30, 2019, for randomized, double-blind, placebo-controlled trials of light therapy in patients with BD (CRD42019128996). The primary outcome was change in clinician-rated depressive symptom score; secondary outcomes included clinical response, remission, acceptability, and treatment-emergent mood switches. We quantitatively pooled outcomes using meta-analysis with random-effects models. Results We identified seven trials representing 259 patients with BD. Light therapy was associated with a significant improvement in Hamilton Depression Rating Scale score (standardized mean difference = 0.43, 95% confidence interval [CI], 0.04 to 0.82, P = 0.03). There was also a significant difference in favor of light therapy for clinical response (odds ratio [ OR] = 2.32; 95% CI, 1.12 to 4.81; P = 0.024) but not for remission. There was no difference in affective switches between active light and control conditions ( OR = 1.30; 95% CI, 0.38 to 4.44; P = 0.67). Study limitations included different light treatment parameters, small sample sizes, short treatment durations, and variable quality across trials. Conclusion There is positive but nonconclusive evidence that adjunctive light therapy reduces symptoms of bipolar depression and increases clinical response. Light therapy is well tolerated with no increased risk of affective switch.

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Section: Discussionmentioning

confidence: 99%

Section: Figure 1 Shows the Preferred Reporting Items For Systematicmentioning

confidence: 99%

Section: Meta-analyses: Primary Outcomesmentioning

confidence: 99%

Section: Study Discontinuationmentioning

confidence: 99%

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Light Therapy for Patients With Bipolar Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2019

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“…One inherent problem of bright light studies is the choice of an appropriate placebo condition (Eastman, Young, Fogg, Liu, & Meaden, 1998). Several types of placebo or a combination of them are used in placebo-controlled LT studies: dim red light (as opposed to bright blue light), differently timed light (evening vs. morning), an inert placebo (a light box emitting no visible light) or an inert (deactivated) negative ion generator (for examples see (Chojnacka et al, 2016;Eastman, et al, 1998;Sit et al, 2018)). Indeed, due to the lack of an obvious type of placebo treatment, LT studies have been extensively criticized for their flawed experimental design.…”

Section: Light Treatment For Circadian Alignmentmentioning

confidence: 99%

ADHD 24/7: Circadian clock genes, chronotherapy and sleep/wake cycle insufficiencies in ADHD

Korman

Palm

Uzoni

et al. 2018

The World Journal of Biological Psychiatry

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Objectives. The current paper addresses the evidence for circadian clock characteristics associated with Attention-Deficit Hyperactivity Disorder (ADHD), and possible therapeutic approaches based on chronomodulation through bright light therapy. Methods. We review the data reported in ADHD on genetic risk factors for phase-delayed circadian rhythms and on the role of photic input in circadian realignment. Results. Single nucleotide polymorphisms (SNPs) in circadian genes were recently associated with core ADHD symptoms, increased evening-orientation and frequent sleep problems. Additionally, alterations in exposure and response to photic input may underlie circadian problems in ADHD. Bright light (BL) therapy was shown to be effective for realignment of circadian physiology toward morningness, reducing sleep disturbances and bringing overall improvement in ADHD symptoms. The susceptibility of the circadian system to phase shift by timed BL exposure may have broad cost-effective potential implications for the treatment of ADHD. Conclusions. We conclude that further research of circadian function in ADHD should focus on detection of genetic markers (e.g., using human skin fibroblasts) and development of BLbased therapeutic interventions.

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Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials

2020

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A sham-controlled randomized trial of adjunctive light therapy for non-seasonal depression

Cited by 24 publications

References 41 publications

Light Therapy for Patients With Bipolar Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Light Therapy for Patients With Bipolar Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials

ADHD 24/7: Circadian clock genes, chronotherapy and sleep/wake cycle insufficiencies in ADHD

Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials

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