Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial

Sit, Dorothy; McGowan, James; Wiltrout, Christopher T; Diler, Rasim Somer; Dills, John Jesse; Luther, James F.; Yang, Amy; Ciolino, Jody D.; Seltman, Howard; Wisniewski, Stephen R.; Terman, Michael; Wisner, Katherine L.

doi:10.1176/appi.ajp.2017.16101200

Cited by 122 publications

(133 citation statements)

References 29 publications

(41 reference statements)

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“…Six articles consisting of six studies published between 2000 and 2018 were included in this review . Sample size ranged from 27 to 80, with a total of 297 participants (Tables and S4).…”

Section: Resultsmentioning

confidence: 99%

“…All studies were individual RCT . Five studies were conducted at a secondary‐care facility while the level of care of one study was unknown .…”

Section: Resultsmentioning

confidence: 99%

“…With regard to incomplete outcome data, one RCT had a high risk of bias due to a high dropout rate . Three studies had an unclear reporting bias (one study: unable to obtain the research registration; one study: endpoint timing was different from the protocol). The other three studies had a high risk of reporting bias …”

Section: Resultsmentioning

confidence: 99%

“…Outcomes are summarized in Tables and S6. Three RCT reported remission rates from depressive episodes after BLT as the primary study outcome . Remission rates from depressive episodes in two other studies were calculated by using depressive symptom scores .…”

Section: Resultsmentioning

confidence: 99%

“…However, this meta‐analysis had some limitations that might have affected its results: (i) most included studies were not RCT; (ii) articles were limited to the English language; (iii) databases other than PubMed and http://clinicaltrials.gov were not searched; and (iv) one study consisted of 70% of subjects with major depressive disorder . In addition, recent RCT that examined the efficacy of BLT for BD were not included in this meta‐analysis . Importantly, no meta‐analysis so far has examined the efficacy of BLT for manic states, or for preventing the recurrence of mood episodes in BD.…”

mentioning

confidence: 99%

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Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Takeshima

Utsumi

Aoki

et al. 2020

Psychiatry Clin Neurosci

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Aim This systematic review and meta‐analysis evaluated whether bright light therapy (BLT) is an effective and safe treatment for manic/depressive symptoms and a preventive measure for recurrent mood episodes in patients with bipolar disorder. Methods A literature search of major electronic databases was conducted in June 2019, including all published articles up to that date. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Results Six randomized controlled trials (RCT) evaluated the efficacy of BLT for bipolar depression. A meta‐analysis found no significant differences between BLT and placebo for the following outcomes: (i) rates of remission from depressive episodes (risk ratio [RR]: 1.81, 95% confidence interval [CI]: 0.43 to 7.64, P = 0.42); (ii) depressive symptom scores (standardized mean difference: −0.25, 95%CI: −0.74 to 0.23, P = 0.30); and (iii) rates of manic switching (RR: 1.00, 95%CI: 0.28 to 3.59, P = 0.26). The sensitivity analysis for studies with low overall indirectness did show a significant antidepressant effect for BLT (RR: 3.09, 95%CI: 1.62 to 5.90, P = 0.006). No RCT investigated the effect of BLT in preventing the recurrence of mood episodes in the euthymic state or in improving manic symptoms in the manic state. No severe adverse events were reported. Conclusion While a meta‐analysis was unable to demonstrate the efficacy of BLT for bipolar depression, a sensitivity analysis did show a significant effect. Further well‐designed studies are needed to clarify the effectiveness of BLT, not only for the depressive state but also for other states, in the treatment of bipolar disorder.

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“…Six articles consisting of six studies published between 2000 and 2018 were included in this review . Sample size ranged from 27 to 80, with a total of 297 participants (Tables and S4).…”

Section: Resultsmentioning

confidence: 99%

“…All studies were individual RCT . Five studies were conducted at a secondary‐care facility while the level of care of one study was unknown .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Takeshima

Utsumi

Aoki

et al. 2020

Psychiatry Clin Neurosci

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Real-time Mobile Monitoring of the Dynamic Associations Among Motor Activity, Energy, Mood, and Sleep in Adults With Bipolar Disorder

et al. 2019

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IMPORTANCE Biologic systems involved in the regulation of motor activity are intricately linked with other homeostatic systems such as sleep, feeding behavior, energy, and mood. Mobile monitoring technology (eg, actigraphy and ecological momentary assessment devices) allows the assessment of these multiple systems in real time. However, most clinical studies of mental disorders that use mobile devices have not focused on the dynamic associations between these systems. OBJECTIVES To examine the directional associations among motor activity, energy, mood, and sleep using mobile monitoring in a community-identified sample, and to evaluate whether these within-day associations differ between people with a history of bipolar or other mood disorders and controls without mood disorders.

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Bright Light Therapy as Add-On to Inpatient Treatment in Youth With Moderate to Severe Depression

Legenbauer,

Kirschbaum-Lesch,

Jörke

et al. 2024

JAMA Psychiatry

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ImportanceMajor depressive disorder is one of the most common mental disorders among adolescents, entailing severe, long-term psychosocial impairment and a high risk of chronicity. In view of the large number of patients requiring treatment, along with insufficient treatment responses with small effect sizes, innovative adjunctive treatment strategies are urgently needed.ObjectiveTo investigate whether the effect of adolescent psychiatric inpatient treatment as usual for major depressive disorder can be enhanced by simultaneous use of morning bright light therapy.Design, Setting, and ParticipantsThis was a double-blind, placebo-controlled randomized parallel-group trial with enrollment between March 2018 and November 2020 and follow-up completed in May 2021. The study took place among inpatients at 4 university hospitals for child and adolescent psychiatry across Germany. Of 248 eligible youth aged 12 to 18 years fulfilling ICD-10 criteria for major depressive disorder, 227 were randomized to bright light therapy (n = 116) or placebo red light (n = 111); 151 participants completed the study.InterventionsUp to 20 sessions of either morning bright light therapy with an intensity of 10 000 lux or placebo red light (100 lux) in addition to multimodal inpatient treatment as usual over 4 weeks.Main Outcomes and MeasuresThe primary outcome was the change in Beck Depression Inventory-II (BDI-II) score from baseline to posttreatment in the intention-to-treat sample.ResultsAmong the 224 patients included in the intention-to-treat analyses (192 girls and 32 boys; mean [SD] age, 15.5 [1.4] years), the mean (SD) BDI-II score at baseline was 37.3 (8.7). BDI-II scores were significantly reduced after 4 weeks (postassessment) by a mean of −7.5 (95% CI, −9.0 to −6.0; Hedges g = 0.71). Bright light therapy had no impact on this change (no significant group × time effect). Loss to follow-up was 31% (n = 69) at 16 weeks and 49% (n = 110) at 28 weeks. There were 10 serious adverse events throughout the whole trial, which were not considered related to study treatment.Conclusions and RelevanceThe findings in this study did not indicate superiority of bright light therapy over placebo red light therapy in a large sample of adolescent inpatients with moderate or severe major depressive disorder. Both groups benefited equally from treatment as usual, showing relevant symptom reduction.Trial RegistrationGerman Clinical Trials Register: DRKS00013188

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Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial

Abstract: The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression.

Cited by 122 publications

References 29 publications

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Real-time Mobile Monitoring of the Dynamic Associations Among Motor Activity, Energy, Mood, and Sleep in Adults With Bipolar Disorder

Bright Light Therapy as Add-On to Inpatient Treatment in Youth With Moderate to Severe Depression

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