Light Treatment in Depressive Illness

Abstract

Objective and subjective quality of sleep and awakening as well as circadian rhythms in Cortisol, temperature and well-being were investigated in 10 female hospitalized depressed patients diagnosed as major depressive disorders according to RDC criteria before (baseline), during (intervention) and after (recovery) treatment with biologically active or bright light (BL) and were compared with the findings in 10 normals. Polysomnographic evaluation demonstrated in depressed patients an increased sleep latency, decreased total sleep time, attenuated S4 and augmented REM sleep, as well as a shortened REM latency and a statistically significant increased average REM length as compared with normals. BL tended to shorten sleep onset, decrease number of awakenings, increase REM latency and significantly attenuated the average REM length. Subjective sleep quality tended to improve as did the subjective awakening quality after the recovery night. There was, however, a statistically significant improvement of the objetively evaluated quality of awakening and early morning behavior characterized by an improved attention, reaction time and performance in the reaction time task, while concentration and psychomotor activity tended to improve as well. BL effects were also seen in hormonal secretion patterns: circadian Cortisol secretion maxima occurred earlier in depressed patients than in normals before and after BL treatment, while during BL intervention this difference disappeared. Circadian temperature rhythms did not exhibit any significant findings with the exception of an earlier occurring minimum in depressed patients than in normals after treatment. Finally, subjective well-being as rated by means of an analogue scale was significally worse in depressed patients than normals before but not during and after light treatment. The findings are discussed.

Somatic influences on subjective well-being and affective disorders: the convergence of thermosensory and central serotonergic systems

“…Elevated body temperature at night, a time when thermoregulatory cooling responses are important for sleep onset and sleep quality (Raymann et al, 2005 , 2008 ; Romeijn et al, 2011 ), is the most consistently observed circadian abnormality in depression (Avery et al, 1982b ; Souetre et al, 1988 ; Duncan, 1996 ), an abnormality that typically normalizes with clinical improvement, (e.g., following ECT, antidepressant drug treatment or spontaneous recovery) (Avery et al, 1982a , b ). Although not observed in all studies, a phase advance in the 24-h pattern of body temperature has also been described in some depressed patients (Dietzel et al, 1986 ; Goetze and Tolle, 1987 ; Souetre et al, 1988 ; Parry et al, 1989 ). Interestingly, despite the higher nocturnal temperature in depressed patients, there is no concomitant increase in nighttime sweating (Avery et al, 1999 ).…”

Testing the Hypothesis of a Circadian Phase Disturbance Underlying Depressive Mood in Nonseasonal Depression

“…Although the hypothesis of a circadian phase disturbance underlying depression is discussed in most of the literature, a controlled study of light exposure with the purpose of shifting circadian rhythms in nonseasonal depressives hardly ever is carried out. Either light is given both in the morning and in the evening (Dietzel et al, 1986;Peter, 1986;Kripke et al, 1987Kripke et al, , 1992 or light exposure at other sensitive phases of the biological clock is not avoided (Deltito et al, 1991;Bauer, 1993;Thalén et al, 1995). Obviously, both approaches are inadequate to induce systematic shifts in circadian rhythms.…”

Blood serotonin, serum melatonin and light therapy in healthy subjects and in patients with nonseasonal depression

“…The action of light is not confined to seasonal affective disorder (SAD); bright light attenuates depressive symptoms in non-SAD patients. However, the effects are minimal and controversial (8)(9)(10)(11)(12)(13)(14).…”